Noninvasive mechanical ventilation in emergency services in Catalonia: the VNICat registry cohort study
Jacob J, Arranz M, Sancho Ramoneda M, López A
, Navarro Sáez MC, Cousiño Chao JR, López Altimiras X, López i Vengut F, García Trallero O, Zorrilla J, German A, Farré Cerdà J, Grupo de trabajo VMNI-SoCMUE
Affiliation of the authors
Servicio de Urgencias, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain. Servicio de Urgencias, Hospital de Viladecans, Barcelona, Spain. Servicio de Urgencias, Hospital Universitari Josep Trueta, Girona, Spain. Sistema d'Emergències Mèdiques. Servicio de Urgencias, Coorporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain. Servicio de Urgencias, Hospital Sant Jaume de Calella, Barcelona, Spain. Servicio de Urgencias, Hospital de Mollet, Mollet del Vallès, Barcelona, Spain. Servicio de Urgencias, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. Servicio de Urgencias, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain. Servicio de Urgencias, Xarxa Assistencial de Manresa, Fundació Althaia, Barcelona, Spain. Servicio de Urgencias, Hospital Universitari Mútua de Terrassa, Barcelona, Spain. Servicio de Urgencias, Hospital Sant Pau i Santa Tecla, Tarragona, Spain.
Jacob J, Arranz M, Sancho Ramoneda M, López A
, Navarro Sáez MC, Cousiño Chao JR, et al. Noninvasive mechanical ventilation in emergency services in Catalonia: the VNICat registry cohort study. Emergencias. 2017;29:33-8
To study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality.
Methods.
Prospective analysis of a consecutive multicenter cohort of patients who were treated with NIV between February and March 2015. The study was undertaken in emergency medical services in Catalonia and 8 Catalan hospital emergency departments. We collected information during the acute episode and on discharge, as well as data describing the patients’ condition when stable. The dependent variable was all-cause hospital mortality.
Results.
We studied 184 acute episodes requiring NIV, in the prehospital setting in 25 cases (13.6%) and in the hospital in 159 (86.4%). The most common scenario was acute heart failure (AHF) (38.0%). The second most common was chronic obstructive pulmonary disease (COPD) (34.2%). In most cases, NIV was discontinued in the emergency department. Mortality was 7.5% during prehospital care and 21.4% in the hospital. Hospital mortality was associated with limiting the use of life support. We detected no significant differences in mortality between the groups of patients
with AHF vs COPD.
Conclusions.
The use of NIV in prehospital and hospital emergency care follows current evidence-based recommendations and is required more often for AHF than for exacerbated COPD. Hospital mortality is high in this context and is associated with frequent limiting of life support.
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