The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

THE CURRENT USE OF NON-INVASIVE MECHANICAL VENTILATION WITH CYSTIC FIBROSIS PATIENTS: A NATIONAL STUDY

Sarah M. Varekojis, PhD RRT, Christina L. Ayotte, BS CRT; The Ohio State University, Columbus, Ohio

BACKGROUND: Currently, respiratory therapy techniques are the primary means to extend and improve the quality of life for the cystic fibrosis (CF) patient. An emerging respiratory therapy technique that may have an application in the CF population is non-invasive positive pressure mechanical ventilation (NPPV). However, very little is known about the use of NPPV in CF patients in the United States.

OBJECTIVES:
The purpose of this study was to describe the current practice regarding the use of NPPV at Cystic Fibrosis Foundation (CFF)-accredited care centers, and determined if current practice differed by treatment setting (in-patient vs. home), region of the country (using American Hospital Association classifications), size of care center (number of patients served), average age of CF patient served, or location of care center (major teaching hospital vs. community hospital). In addition, the results of this survey can be used to direct future research efforts regarding the use of NPPV in CF patients.

METHODS
: A survey research design was utilized in this project. The survey instrument was designed to measure the various aspects of NPPV use in CF patients and to obtain demographic information about each CFF-accredited care center. The study population included all CFF-accredited care centers in the United States. The survey instrument was mailed to a respiratory therapist, nurse, or physician directly involved in the care of CF patients with personal, detailed knowledge of the clinical practices of their respective care center. This professional was identified by contacting each care center prior to mailing the survey instrument. The completed surveys were analyzed with SPSS, utilizing Chi-squares, t-tests and descriptive statistics.

RESULTS:
159 of 244 care centers listed on the database were contacted and 74 surveys were returned, resulting in a 46.5% response rate. Impending respiratory failure was the most common indication for in-patient use of NPPV, while nocturnal hypoventilation was the most common indication for home use of NPPV. NPPV was used for less than 5% of patients in both in-patient and home settings. Nasal BiPAP was the most common method of administration of NPPV in both settings.

CONCLUSIONS:
The majority of CFF-accredited centers are using NPPV for both in-patient and home populations. NPPV is used with a very small, very specific patient population. For both in-patient and home use there is a trend toward the use of nasal BiPAP NPPV for short-term treatment of respiratory failure and hypoventilation. No clinically significant differences in practice based on treatment setting, region, size of care center, average age of patient served, or location were determined.

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