PURPOSE: International guidelines recommend that hospitals that treat patients with acute type II respiratory failure should have access for acute BiPAP in addition to conventional medical therapy. We have limited published data on operational aspect of the use of acute BiPAP in relation to accepted guidelines in our hospital. The aim of the study is to determine use of non-invasive positive pressure ventilation (BIPAP) application in relation to accepted guidelines and compare our result in relation to the need for mechanical ventilation, hospital mortality and hospital length of stay.
METHODS: A prospective study on consecutive patients admitted with acute type II respiratory failure was done at section of pulmonology, Stavanger University Hospital from February 2005 to June 2005.
RESULTS: A total of 53 patients were admitted with acute type II respiratory failure. Mechanical ventilation was required in 20.8 % of cases. 18.9 % of patient died. 6 of 10 patients who died were were not considered candidates for mechanical ventilation from the very beginning. 14.3 % patients did not tolerate BiPAP machine for different reasons. Average hospital stay was 12 days (CI 8.8-16.6); while hospital stays in pulmonary acute care unit was 2.3 days (CI 1.8-2.7). 93.4 % of patient’s have known COLD diagnosis and 52.1 % of patients had documented chronic respiratory failure. 41.7 % of patients had known cardiovascular diseases. 29.2 % of patients had positive TNT (> 0.04 ng/mL). 62.5 % of patient’s har sepsis diagnosis in relations to SIRS criteria. 39.6 % of patients had chest x-ray finding compatible with pneumonia. The patients waited on average 100.1 minutes (CI 47.8-154.8) to get acute BiPAP machine.
CONCLUSION: The percentage of successful BiPAP application and mortality associated with acute type II respiratory failure is comparable with some other studies. The study has showed some shortcomings in BiPAP application.
CLINICAL IMPLICATIONS: Patients admitted with acute type II respiratory failures have high mortality and there is a need for better organisation and routine in management of these groups of pasients.
DISCLOSURE: Tesfaye Madebo, None.