Mortality in acute patients treated with noninvasive ventilation (NIV)

Objective: To evaluate the mortality of patients with NIV,in a general way and by disease and to determine whether there are differences between the group that survives against the group that passes away. Methods: We evaluated patients in acute respiratory failure and treated with NIV in our hospital from 2008 to 2010.General data,blood gases,pathology and treatment criteria were analyzed and compared. Results: n=598.Overall mortality was 17.8%.The mortality related to respiratory failure was 11.3%. In a subgroup of 170 patients,we analyzed whether the NIV was carried out due to clinical-gasometric criteria,limitation of therapeutic effort (LTE, without intensive care unit admission criteria) or palliative criteriaWe find significant differences between groups,showing that more than 1/2 of the deceased (66%) had a palliative criteria.The mortality of LTE was approximately 1 out of 4.Mortality from pathology was (% of the total for each pathology): COPD (11%) with or without other pathology (6%) vs (4%), interstitial lung disease (55%), OHS (5.2%), kyphoscoliosis (17%), heart failure (16%) and neuromuscular disease (41%).When comparing epidemiological data, comorbidities, pH,PCO2 and side effects between the group died and those who survived after treatment, we founded significant differences in the deceased group:older,less obese. Conclusions: -It is necessary to permormance a detailed analysis of mortality in each group of pathology.In COPD and OHS, which are the most ventilated, it is quite worthwhile to carry out NIV.-The palliative patients group increase mortality rates so it is very important to analyze this group separately.-To carry out NIV may be an alternative for patients who do not fulfil ICU admission criteria.