Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation*

Levy, Mitchell M.; Tanios, Maged; Nelson, David L.; Short, Kathy A.; Senechia, Anthony; Vespia, John; Hill, Nicholas S.

doi:10.1097/01.ccm.0000142729.07050.c9

Cited by 171 publications

(90 citation statements)

References 18 publications

(20 reference statements)

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“…Withdrawing was rarely used in European RICUs, mainly because NIMV was used as the ceiling of ventilatory care in almost a third of the patients. Indeed, NIMV has been used increasingly as an alternative to invasive ventilation in patients with a DNI order [17,18]. In a recent study [17], NIMV was applied to treat episodes of acute respiratory failure in 114 patients with DNI orders.…”

Section: Ethical Decisions In Respiratory Intermediate Care Units S mentioning

confidence: 99%

“…Indeed, NIMV has been used increasingly as an alternative to invasive ventilation in patients with a DNI order [17,18]. In a recent study [17], NIMV was applied to treat episodes of acute respiratory failure in 114 patients with DNI orders. Approximately half of the patients survived and were discharged from the ICU.…”

Section: Ethical Decisions In Respiratory Intermediate Care Units S mentioning

confidence: 99%

See 1 more Smart Citation

End-of-life decision-making in respiratory intermediate care units: a European survey

Nava

Sturani²,

Hartl³

et al. 2007

European Respiratory Journal

129

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A survey was performed on behalf of the European Respiratory Society to assess end-of-life practices in patients admitted to European respiratory intermediate care units and high dependency units over a 6-month period.A 33-item questionnaire was sent by e-mail to physicians throughout Europe and the response rate was 28 (29.5%) out of 95. A total of 6,008 patients were admitted and an end-of-life decision was taken in 1,292 (21.5%). The mortality rate in these patients was 68% (884 out of 1,292).The patients received similar proportions of withholding of treatment (298 (23%) out of 1292), do-not-resuscitate or do-not-intubate orders (442 (34%) out of 1,292) and noninvasive mechanical ventilation as the ceiling of ventilatory care (402 (31%) out of 1,292). Withdrawal of therapy was employed in 149 (11%) out of 1,292 patients and euthanasia in one. Do-not-intubate/do-notresuscitate orders were more frequently used in North compared with South Europe. All of the 473 competent patients directly participated in the decision, whereas, in 722 (56%) out of 1,292 cases, decision-making was reported to be shared with the nurses.In European respiratory intermediate care units and high dependency units, an end-of-life decision is taken for 21.5% of patients admitted. Withholding of treatment, do-not-intubate/do-notresuscitate orders and noninvasive mechanical ventilation as the ventilatory care ceiling are the most common procedures. Competent patients are often involved, together with nurses.

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Section: Ethical Decisions In Respiratory Intermediate Care Units S mentioning

confidence: 99%

Section: Ethical Decisions In Respiratory Intermediate Care Units S mentioning

confidence: 99%

End-of-life decision-making in respiratory intermediate care units: a European survey

Nava

Sturani²,

Hartl³

et al. 2007

European Respiratory Journal

129

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“…NPPV is an alternative to invasive ventilation for symptom relief in end-stage COPD [106][107][108], and a recent European survey of respiratory intermediate care units reported a frequency of use and its role in almost a third of patients among those with poor life expectancy [109]. NPPV reduces dyspnoea even in the absence of hypercapnic respiratory failure [110].…”

Section: Nppv In Palliative Carementioning

confidence: 99%

Nonpharmacological treatment and relief of symptoms in COPD

Clini

Ambrosino²

2008

European Respiratory Journal

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Evidence-based guidelines for chronic obstructive pulmonary disease (COPD) have recently been developed.Nonpharmacological treatments have evolved rapidly as an essential part of COPD therapy. They are especially important as complementary interventions in severe or very severe disease, when there is loss in function, a reduction in quality of life and when psychological impairments further complicate the disease.The present article discusses the most used nonpharmacological treatments for severe COPD patients (rehabilitation, long-term oxygen therapy, surgery, noninvasive positive pressure ventilation and supportive nutrition) and their evidence-based usefulness in promoting strategies that relieve symptoms.All of these interventions are used during end-stage disease, to promote self-efficacy, relieve symptoms and prevent further deterioration. These therapeutic options support physicians and allied professionals in improving symptom management for their patients.

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“…A recent study 46 that included 114 patients with a do-not-intubate order and acute respiratory failure found that 43% of patients survived to hospital discharge. The patient's underlying condition was an important determinant of survival.…”

Section: Noninvasive Ventilation In Patients With a "Do-notintubate" mentioning

confidence: 99%

Noninvasive positive-pressure ventilation in acute respiratory failure

Peñuelas

Frutos‐Vivar²,

Esteban³

2007

Canadian Medical Association Journal

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Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation*

Cited by 171 publications

References 18 publications

End-of-life decision-making in respiratory intermediate care units: a European survey

End-of-life decision-making in respiratory intermediate care units: a European survey

Nonpharmacological treatment and relief of symptoms in COPD

Noninvasive positive-pressure ventilation in acute respiratory failure

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