The application of non-invasive and invasive mechanical ventilation in the first episode of acute respiratory failure

Cheng-Chi Huang, Chih-Hsin Muo, Tain-Fung Wu, Tung-Yun Chi, Te-Chun Shen, Te-Chun Hsia, Chuen-Ming Shih, Cheng-Chi Huang, Chih-Hsin Muo, Tain-Fung Wu, Tung-Yun Chi, Te-Chun Shen, Te-Chun Hsia, Chuen-Ming Shih

Abstract

Acute respiratory failure (RF) is a life-threatening syndrome. This study investigated the application of two major clinical strategies, non-invasive mechanical ventilation (NIV) and invasive mechanical ventilation (IMV), in the first episode of acute RF. Data from the longitudinal health insurance database, which included 1,000,000 insured citizens, were used. The NIV group consisted of 1201 patients and the IMV group consisted of 16,072 patients. Chi-square test and t test were applied to determine the differences in categorical and continuous variables. Further analysis was performed by using univariate and multivariable logistic regression and Poisson regression. There was a significant increase of 733% in the number of NIV users from 2000 to 2012. NIV use was frequently observed in old-age persons (aOR 3.99, 95% CI 3.06-5.21 for those aged ≥ 80 years), women (aOR 1.33, 95% CI 1.18-1.50), patients admitted to a high-level hospital (aOR 1.95, 95% CI 1.63-2.34 for those admitted to a medical center), and patients with a higher Charlson comorbidity index (CCI, aOR 1.38-1.66 for those CCI ≥ 2). In addition, patients with chronic pulmonary disease, cancer, and congestive heart failure were predominant in NIV users and were significantly associated with NIV use. Overall, the use of NIV has markedly increased over the past few years. Persons of advanced age, women, patients admitted to a high-level hospital, and patients with multiple comorbidities were associated with more frequent NIV use. Chronic pulmonary disease, cancer, and congestive heart failure were most important comorbidities for NIV use.

Keywords: Acute respiratory failure (acute RF); Intensive care; Invasive mechanical ventilation (IMV); Non-invasive mechanical ventilation (NIV).

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Individuals in the NIV group and the IMV group between 2000 and 2012
Fig. 2
Fig. 2
Probability of the NIV group and the IMV group between 2000 and 2012

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