Outcome of Frail Do-Not-Intubate Subjects With End-Stage Chronic Respiratory Failure and Their Opinion of Noninvasive Ventilation to Reverse Hypercapnic Coma.
Advance Directives
/ psychology
Aged
Aged, 80 and over
Case-Control Studies
Chronic Disease
Coma
/ etiology
Female
Frail Elderly
/ psychology
Humans
Hypercapnia
/ etiology
Intubation, Intratracheal
/ psychology
Male
Middle Aged
Noninvasive Ventilation
/ psychology
Prospective Studies
Respiratory Insufficiency
/ complications
COPD
do-not-intubate order
do-not-resuscitate orders
noninvasive ventilation
obesity hypoventilation syndrome
respiratory insufficiency
Journal
Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
pubmed:
21
3
2019
medline:
31
7
2020
entrez:
21
3
2019
Statut:
ppublish
Résumé
The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication. A prospective observational case-control study was conducted in 3 French tertiary care hospitals during a 2-y period. Forty-three individuals who were comatose (with pH < 7.25 and P NIV yielded similar outcomes in the 2 groups regarding in-hospital mortality ( In the frailest subjects with supposed end-stage chronic respiratory failure that justifies treatment limitation decisions, it is worth trying NIV when acute hypercapnic respiratory failure occurs, even in the case of extreme respiratory acidosis with hypercapnic coma at admission.
Sections du résumé
BACKGROUND
BACKGROUND
The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication.
METHODS
METHODS
A prospective observational case-control study was conducted in 3 French tertiary care hospitals during a 2-y period. Forty-three individuals who were comatose (with pH < 7.25 and P
RESULTS
RESULTS
NIV yielded similar outcomes in the 2 groups regarding in-hospital mortality (
CONCLUSIONS
CONCLUSIONS
In the frailest subjects with supposed end-stage chronic respiratory failure that justifies treatment limitation decisions, it is worth trying NIV when acute hypercapnic respiratory failure occurs, even in the case of extreme respiratory acidosis with hypercapnic coma at admission.
Identifiants
pubmed: 30890633
pii: respcare.06346
doi: 10.4187/respcare.06346
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1023-1030Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 by Daedalus Enterprises.
Déclaration de conflit d'intérêts
The authors have disclosed no conflicts of interest.