Intensive Care Medicine

, Volume 32, Issue 11, pp 1747–1755

Increased use of noninvasive ventilation in French intensive care units

  • Alexandre Demoule
  • Emmanuelle Girou
  • Jean-Christophe Richard
  • Solenne Taillé
  • Laurent Brochard
Original

DOI: 10.1007/s00134-006-0229-z

Cite this article as:
Demoule, A., Girou, E., Richard, JC. et al. Intensive Care Med (2006) 32: 1747. doi:10.1007/s00134-006-0229-z

Abstract

Objectives

A prospective survey of French intensive care units (ICUs) in 1997 showed moderate and variable use of noninvasive ventilation (NIV). This study examined changes in NIV use in French ICUs after the intervening 5 years.

Settings

Patients were enrolled in a prospective survey in 70 French ICUs.

Methods

Three-week survey, with prospective inclusion of all patients requiring ventilatory support.

Measurements and results

Overall 1,076 patients received ventilatory support (55% of admissions). First-line NIV was significantly more common than 5 years earlier, overall (23% vs. 16%) and especially in patients not intubated before ICU admission (52% vs. 35%). Reasons for respiratory failure were coma (33%), cardiogenic pulmonary edema (8%), acute-on-chronic respiratory failure (17%), and de novo respiratory failure (41%). Significant increases in NIV use were noted for acute-on-chronic respiratory failure (64% vs. 50%) and de novo respiratory failure (22% vs. 14%). Among patients given NIV, 38% subsequently required endotracheal intubation (not significantly different). Independent risk factors for NIV failure were high SAPS II and de novo respiratory failure, whereas factors associated with success were good NIV tolerance and high body mass index.

Conclusions

NIV use has significantly increased in French ICUs during the past 5 years, and the success rate has remained unchanged. In patients not previously intubated, NIV is the leading first-line ventilation modality. The proportion of patients successfully treated with NIV increased significantly over the 5-year period (13% vs. 9% of all patients receiving ventilatory support).

Keywords

Acute respiratory failureCardiogenic pulmonary edemaChronic obstructive pulmonary diseasePneumoniaEndotracheal intubation

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Alexandre Demoule
    • 1
    • 2
  • Emmanuelle Girou
    • 2
    • 3
    • 4
  • Jean-Christophe Richard
    • 5
  • Solenne Taillé
    • 1
  • Laurent Brochard
    • 1
    • 2
    • 6
  1. 1.Service de Réanimation MédicaleAP-HP, Hôpital Henri MondorCréteilFrance
  2. 2.Faculté de MédecineUniversité Paris 12CréteilFrance
  3. 3.CEPIAP-HP, Hôpital Henri MondorCréteilFrance
  4. 4.CeRBEP-INSERM U657Institut PasteurParisFrance
  5. 5.Réanimation MédicaleHôpital Charles NicolleRouenFrance
  6. 6.INSERM U 651CréteilFrance