Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study

• Main Authors: Hyunseung Nam, M.D., Jae Hwa Cho, M.D., Ph.D., Eun Young Choi, M.D., Youjin Chang, M.D., Won-Il Choi, M.D., Ph.D., Jae Joon Hwang, M.D., Jae Young Moon, M.D., Ph.D., Kwangha Lee, M.D., Sei Won Kim, M.D., Hyung Koo Kang, M.D., Yun Su Sim, M.D., Tai Sun Park, M.D., Seung Yong Park, M.D., Sunghoon Park, M.D., Ph.D., on behalf of Korean NIV Study Group
• Format: Article
• Language: English
• Published: The Korean Academy of Tuberculosis and Respiratory Diseases 2019-07-01
• Series: Tuberculosis and Respiratory Diseases
• Subjects: intensive care units; noninvasive ventilation; masks
• Online Access: https://www.e-trd.org/search.php?where=aview&id=10.4046/trd.2018.0064&code=0003TRD&vmode=FULL
• ISSN: 1738-3536; 2005-6184

Background Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results A total of 156 patients treated with NIV were enrolled (mean age, 71.9±11.6 years). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.