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Increasing severity with unchanged in-hospital mortality in acute hypercapnic respiratory failure (AHRF) at a respiratory ward-based non-invasive ventilation (NIV) unit

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dc.contributor.authorJumaa Bwika,en_US
dc.contributor.authorShiva Bikmalla,en_US
dc.contributor.authorHannah Lewis,en_US
dc.contributor.authorBiman Chakraborty,en_US
dc.contributor.authorNorashikin Amran,en_US
dc.contributor.authorBen Beauchamp,en_US
dc.contributor.authorJoshil Lodhia,en_US
dc.contributor.authorRahul Mukherjeeen_US
dc.date.accessioned2024-05-28T04:29:09Z
dc.date.available2024-05-28T04:29:09Z
dc.date.issued2013
dc.description.abstractIntroduction: There has been a 462% increase in acute NIV use in COPD (Chandra D et al. AJRCCM 2011) over 11 years in the United States with similar changes in the UK, where this has led to the movement of NIV provision out of critical care. We analyse temporal trends in the severity and outcomes of ward-based NIV practices. Methods: In-house NIV registry data compared: 01/08/04 -31/01/06 (Period 1) vs 01/01/11 – 30/06/12 (Period 2) at our 11-bedded ward-based NIV unit in a central England acute hospital, analysing mortality, duration of NIV and initial arterial pH. Results: AHRF: 281 episodes in Period 1 and 240 in Period 2; acute exacerbations of COPD similar proportion (about 70%) in both periods; initial arterial pH significantly lower in Period 2 (median pH 7.280 vs 7.261: see figure); mean duration of NIV was significantly higher (median length of NIV 4 days vs 6 days), in-hospital mortality similar (21.6% vs. 22.7%). Discussion: Compared to 2004, the ward-based NIV unit is treating more severely ill AHRF patients who are spending longer periods under acute NIV with no significant change in mortality. Further analysis of population characteristics, co-morbid risk factors for respiratory failure and Domiciliary NIV/Home Mechanical Ventilation practices are needed to inform health policy/strategies to deal with long term respiratory conditions.en_US
dc.identifier.issn0903-1936
dc.identifier.issueSuppl 57
dc.identifier.other2093-2
dc.identifier.urihttps://erj.ersjournals.com/content/42/Suppl_57/P4760
dc.identifier.urihttps://oarep.usim.edu.my/handle/123456789/5737
dc.identifier.volume42
dc.language.isoenen_US
dc.publisherEuropean Respiratory Societyen_US
dc.relation.conferenceEuropean Respiratory Society Annual Congress 2013en_US
dc.relation.ispartofEuropean Respiratory Journalen_US
dc.subjectAcute respiratory failureen_US
dc.subjectVentilation/NIVen_US
dc.subjectHealth policyen_US
dc.titleIncreasing severity with unchanged in-hospital mortality in acute hypercapnic respiratory failure (AHRF) at a respiratory ward-based non-invasive ventilation (NIV) uniten_US
dc.typeArticleen_US
dspace.entity.typePublication

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Increasing severity with unchanged in-hospital mortality in acute hypercapnic respiratory failure (AHRF) at a respiratory ward-based non-invasive ventilation (NIV) unit
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