Evolving indications and demographics for domiciliary Non-Invasive Ventilation (NIV) at an acute hospital based NIV service

Livesey, Alana; Antoine-Pitterson, Pearlene; Oakes, Amy; Mallisetty, Pradeep; Turner, Alice; Mukherjee, Rahul

doi:10.1183/13993003.congress-2018.pa2366

Cited by 2 publications

(3 citation statements)

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“…Previous audit papers have flagged that many COPD patients are treated outside the evidence base of the RCTs 4 17–20. In the UK, nearly two-thirds of patients with COPD treated with acute, ward-based NIV have NIV documented as their ‘ceiling of treatment’ which also may also account for the differences observed 21–23. Patients in both these audits were older (average 71.1years) than those reported in the Cochrane review (66.8 years) of NIV in AECOPD patients admitted with hypercapnic respiratory acidosis 10.…”

Section: Discussionmentioning

confidence: 99%

Time to NIV and mortality in AECOPD hospital admissions: an observational study into real world insights from National COPD Audits

et al. 2019

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BackgroundRandomised control trial (RCT)-derived survival figures for acute exacerbation of chronic obstructive pulmonary disease admissions managed with non-invasive ventilation (NIV) have not been replicated in UK clinical audits. Subsequent guidelines have emphasised the need for timely NIV application.MethodsData from the 2008 and 2014 national chronic obstructive pulmonary disease audits was used to analyse the association between time to NIV and mortalityResults1032 patients received NIV in 2008, and 1612 in 2014. Overall mortality rates reduced between the audits from 24.9% in 2008 to 16.8% in 2014 but time to NIV lengthened. In 2014, 20.9% of patients received NIV within 60 min versus 24.9% in 2008 (p=0.001). The proportion of patients receiving NIV between 3 and 24 hours increased from 31.3% in 2008 to 39% in 2014 (p=0.001). Patients admitted with hypercapnic acidotic respiratory failure who received NIV within 3 hours had lower in-patient mortality than those who received NIV between 3 and 24 hours, 15.9% versus 18.4%, but this did not reach statistical significance (p=0.425), but acidotic patients receiving NIV >24 hours after admission had significantly higher mortality (28.9%, p=0.002). A second cohort admitted with hypercapnia but normal range pH, who developed later acidosis, had higher mortality (24.6%), compared with those acidotic on admission (18% p≤0.001) and an extremely high mortality when NIV was given >24 hours after admission (42.6%).ConclusionSurvival rates for those treated with NIV has improved between the two audits but remains lower than reported in RCTs. Patients who developed acidosis after admission and received NIV later in the hospital stay have even higher mortality and deserve further study and clinical attention.

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Section: Discussionmentioning

confidence: 99%

Time to NIV and mortality in AECOPD hospital admissions: an observational study into real world insights from National COPD Audits

et al. 2019

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Section: Introduction and Purposementioning

confidence: 99%

“…2 Conditions managed by domiciliary NIV include obesity hypoventilation syndrome, neuromuscular disease, chest wall disorders, chronic obstructive pulmonary diseases, cystic fibrosis, and noncystic fibrosis bronchiectasis. [2][3][4] Cleaning is defined as the removal of organic material from surfaces, which can be achieved by physically scrubbing with a mild detergent. 5 The Australian guideline for domiciliary NIV 2 recommends that patients' cleaning protocol of NIV equipment should follow the recommendation from the manufacturer.…”

Section: Introduction and Purposementioning

confidence: 99%

Survey of Home Cleaning Practices With Noninvasive Ventilation Equipment

Milross

McGuiness

et al. 2022

Cardiopulm Phys Ther J

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Home noninvasive ventilation (NIV) equipment is often observed to be dirty, potentially increasing patients' risk of respiratory infection. This study aimed to describe the cleaning practices of home NIV patients. Methods: This single-site, cross-sectional, observational study surveyed 100 patients from the respiratory failure clinic regarding cleaning instructions, cleaning habits, barriers, and motivators to cleaning. Open-ended responses were analyzed with basic content analysis and closed categorical responses with frequencies and percentages. Results: Of 100 participants, 77% responded. Cleaning instructions most commonly recalled included cleaning with soapy water for masks (26/47, 55%), head straps (19/47, 40%), and tubing (21/47, 45%); vinegar solution for humidifiers (9/39, 23%); and replacing filters (14/39, 36%). Fourteen respondents reported barriers to cleaning, including forgetfulness (7/14, 50%) and physical difficulties (6/14, 43%). Commonly reported cleaning practices included soapy water to soak masks (28/77, 36%) and tubing (35/77, 46%), weekly masks (34/77, 44%) and tubing cleaning (29/77, 38%), vinegar solution to clean humidifiers for the 36 humidifier users (15/36, 44%), monthly humidifier cleaning (13/36, 36%), and monthly filter cleaning/replacement (36/77, 47%). Conclusion: Few respondents could recall specific instructions about when and how to clean their equipment. Many reported routine cleaning, with varied methods and frequencies. Our results will inform future NIV equipment cleaning educational package design.

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Evolving indications and demographics for domiciliary Non-Invasive Ventilation (NIV) at an acute hospital based NIV service

Cited by 2 publications

References 0 publications

Time to NIV and mortality in AECOPD hospital admissions: an observational study into real world insights from National COPD Audits

Time to NIV and mortality in AECOPD hospital admissions: an observational study into real world insights from National COPD Audits

Survey of Home Cleaning Practices With Noninvasive Ventilation Equipment

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