Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups

作者：Ugurlu Aylin Ozsancak^*; Sidhom Samy S; Khodabandeh Ali; Ieong Michael; Mohr Chester; Lin Denis Y; Buchwald Irwin; Bahhady Imad; Wengryn John; Maheshwari Vinay; Hill Nicholas S

来源：Respiratory Care, 2016, 61(1): 36-43.

DOI：10.4187/respcare.03966

• noninvasive ventilation
• acute respiratory failure
• elderly
• aged
• middle-aged

BACKGROUND: The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups. METHODS: A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used. RESULTS: From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18-44 y); 34, 65, and 13% in middle-aged (45-64 y); 49, 68, and 17% in elderly (65-79 y); and 47, 76, and 24% in aged (>= 80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively). CONCLUSIONS: NIV use and a do-not-intubate status are more frequent in subjects with ARF >= 65 y than in those < 65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups.

• 出版日期2016-1