The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

NON-INVASIVE POSITIVE PRESSURE VENTILATION: OUTCOMES OF INTRODUCING TECHNOLOGY WHICH ADDRESSES THE LIMITATIONS OF GAS LEAK.

Christopher T. DaRosa1, Robert Aisenberg1



Background: NPPV has been demonstrated to be effective in preventing the need for intubation and mechanical ventilation (MV) in patients with acute respiratory failure (RF). However, gas leaks that occur around the mask can often affect FiO2 delivery and inspiratory triggering, rendering NPPV ineffective. Unfortunately, little information is available about the benefits of using technology which addresses these limitations.

Methods: The sample included 433 patients with a diagnosis of RF who received NPPV or MV from October 2006 to March 2008 at a 328-bed, non-teaching, community hospital. Data were extracted from the hospital's coding and financial management systems and included patient diagnosis, number of cases, number of device days and device length-of-stay. In October 2007, we began using NPPV technology to address the more traditional treatment limitations described above. To determine the effectiveness of this new technology, we compared NPPV and MV usage in RF patients after this technology was implemented to the similar patients who did not receive this technology during the previous fiscal year.

Results: Between October 1, 2007, and March 31, 2008, 179 RF patients required ventilatory support with NPPV or MV. Results indicated 58% of the RF patients benefited from the use of NPPV compared to 46% in the previous group with a corresponding decrease in the number of MV patients, reducing our intubation rate by 11% in patients with RF.

Conclusion: Our data suggests that using NPPV technology, which addresses the limitations of gas leak, resulted in increased use of NPPV, thereby, preventing the need for intubation and MV in patients with RF.