Noninvasive mechanical ventilation in emergency services in Catalonia: the VNICat registry cohort study

Objectives: To study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality. Material and methods: Prospective analysis of a consecutive multicenter cohort of patients who were tre...

Descripción completa

Detalles Bibliográficos
Autores: Jacob, Javier, Arranz, Maria J., Sancho Ramoneda, Mariona, Lopez, Àngels, Navarro Sáez, Ma Carmen, Cousiño Chao, José Ramón, López Altimiras, Xavier, López i Vengut, Francesc, García Trallero, Olivia, Zorrilla, José, German, Antonio, Farré Cerdà, Jaume, Lista, Eva
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/185650
Acceso en línea:https://hdl.handle.net/2445/185650
Access Level:acceso abierto
Palabra clave:Serveis d'urgències mèdiques
Insuficiència respiratòria
Catalunya
Respiració artificial
Emergency medical services
Respiratory insufficiency
Catalonia
Artificial respiration
Descripción
Sumario:Objectives: To study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality. Material and methods: Prospective analysis of a consecutive multicenter cohort of patients who were treated with NIV between February and March 2015. The study was undertaken in emergency medical services in Catalonia and 8 Catalan hospital emergency departments. We collected information during the acute episode and on discharge, as well as data describing the patients' condition when stable. The dependent variable was all-cause hospital mortality. Results: We studied 184 acute episodes requiring NIV, in the prehospital setting in 25 cases (13.6%) and in the hospital in 159 (86.4%). The most common scenario was acute heart failure (AHF) (38.0%). The second most common was chronic obstructive pulmonary disease (COPD) (34.2%). In most cases, NIV was discontinued in the emergency department. Mortality was 7.5% during prehospital care and 21.4% in the hospital. Hospital mortality was associated with limiting the use of life support. We detected no significant differences in mortality between the groups of patients with AHF vs COPD. Conclusion: The use of NIV in prehospital and hospital emergency care follows current evidence-based recommendations and is required more often for AHF than for exacerbated COPD. Hospital mortality is high in this context and is associated with frequent limiting of life support.