To view the full text, please login as a subscribed user or purchase a subscription.
Click here to view the full text on ScienceDirect.
Abstract
Objective
Out-of-hospital clinical experience with noninvasive bilevel positive airway pressure (BiPAP) ventilation is extremely limited compared to inhospital management. The aims of this study were to assess the feasibility of out-of-hospital BiPAP ventilation in patients with acute respiratory distress of various origins, and to look for specific factors associated with failure of this respiratory support.
Methods
This 2-year prospective observational study assessed the failure rate of out-of-hospital BiPAP ventilation, the difficulties encountered, and factors predictive of failure by multivariate analysis.
Results
Overall, 138 patients were treated by out-of-hospital BiPAP for congestive heart failure (56%), chronic obstructive pulmonary disease exacerbation (28%), and acute respiratory failure (16%). Failure rate was 26% (35/138; 95% confidence interval, 18%-33%) (11 before and 24 after reaching hospital). Independent risk factors were the cause of respiratory distress (chronic obstructive pulmonary disease exacerbation; acute respiratory failure) and an audible air leakage.
Conclusions
The failure rate of BiPAP initiated out-of-hospital was no different from previous reports for inhospital failure rates. Failure was attributable to similar causes.
To access this article, please choose from the options below
☆This work was performed in the Service de Médecine d'Urgence et de Réanimation (SMUR) of Henri-Mondor University Hospital and Paris XII Val-De-Marne School of Medicine 94000 Créteil.
☆☆This work received support from Department sources.
This work was presented in part at the annual meeting of the Société Française d'Anesthésie et de Réanimation, Paris, France, September 2005.
