Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 14;12(18):5973.
doi: 10.3390/jcm12185973.

Clinical Outcomes according to Timing to Non Invasive Ventilation Initiation in COPD Patients with Acute Respiratory Failure: A Retrospective Cohort Study

Lara Pisani  1   2 , Gabriele Corsi  1   2 , Marco Carpano  1   2 , Gilda Giancotti  1 , Maria Laura Vega  1   2 , Vito Catalanotti  2 , Stefano Nava  1   2
Affiliations

Clinical Outcomes according to Timing to Non Invasive Ventilation Initiation in COPD Patients with Acute Respiratory Failure: A Retrospective Cohort Study

Lara Pisani et al. J Clin Med. .

Abstract

Nighttime and non-working days are characterized by a shortage of dedicated staff and available resources. Previous studies have highlighted that patients admitted during the weekend had higher mortality than patients admitted on weekdays ("weekend effect"). However, most studies have focused on specific conditions and controversial results were reported. We conducted an observational, monocentric, retrospective cohort study, based on data collected prospectively to evaluate the impact of the timing of NIV initiation on clinical outcomes in COPD patients with acute respiratory failure (ARF). A total of 266 patients requiring NIV with a time gap between diagnosis of ARF and NIV initiation <48 h were included. Interestingly, 39% of patients were not acidotic (pH = 7.38 ± 0.09 vs. 7.26 ± 0.05, p = 0.003) at the time of NIV initiation. The rate of NIV failure (need for intubation and/or all-cause in-hospital death) was similar among three different scenarios: "daytime" vs. "nighttime", "working" vs. "non-working days", "nighttime or non-working days" vs. "working days at daytime". Patients starting NIV during nighttime had a longer gap to NIV initiation compared to daytime (219 vs. 115 min respectively, p = 0.01), but this did not influence the NIV outcome. These results suggested that in a training center for NIV management, the failure rate did not increase during the "silent" hours.

Keywords: NIV; acute respiratory failure; daytime; mechanical ventilation; nighttime; non-working days.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Percentage of patients receiving NIV with a pH ≥ 7.35.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Rochwerg B., Brochard L., Elliott M.W., Hess D., Hill N.S., Nava S., Navalesi P., Members of The Steering Committee. Antonelli M., Brozek J., et al. Official ERS/ATS clinical practice guidelines: Noninvasive ventilation for acute respiratory failure. Eur. Respir. J. 2017;50:1602426. doi: 10.1183/13993003.02426-2016. - DOI - PubMed
    1. Brochard L., Isabey D., Piquet J., Amaro P., Mancebo J., Messadi A.A., Brun-Buisson C., Rauss A., Lemaire F., Harf A. Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N. Engl. J. Med. 1990;323:1523–1530. doi: 10.1056/NEJM199011293232204. - DOI - PubMed
    1. Brochard L., Mancebo J., Wysocki M., Lofaso F., Conti G., Rauss A., Simonneau G., Benito S., Gasparetto A., Lemaire F., et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N. Engl. J. Med. 1995;333:817–822. doi: 10.1056/NEJM199509283331301. - DOI - PubMed
    1. Ozyilmaz E., Ugurlu A.O., Nava S. Timing of noninvasive ventilation failure: Causes, risk factors, and potential remedies. BMC Pulm. Med. 2014;14:19. doi: 10.1186/1471-2466-14-19. - DOI - PMC - PubMed
    1. Nava S., Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250–259. doi: 10.1016/S0140-6736(09)60496-7. - DOI - PMC - PubMed

LinkOut - more resources