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Results of Noninvasive Ventilation in Obese Patients With Acute Respiratory Failure FREE TO VIEW

Concepcion Romero, MD; Jesús Sánchez, MD; Virginia Almadana, MD; Ana Gómez-Bastero, MD; Patricia Guerrero, MD; Agustin Valido, MD; Jose María Benítez, MD; Teodoro Montemayor, MD
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H. U. V. Macarena, Sevilla, Spain

Chest. 2014;145(3_MeetingAbstracts):544A. doi:10.1378/chest.1784265
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SESSION TITLE: Respiratory Support Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Non invasive ventilation (NIV) ia a technical support in patients with acute or chronic respiratory failure. The NIV is used in patients with obesity hypoventilation syndrome (OHS) presenting with hypercapnic respiratory failure. Few studies examine the evolution and impact after starting this therapy in this patient group Objectives: To evaluate the result of non invasive ventilation started in obese patients in acute hypercapnic respiratory failure (AHRF) and its prognosis consequences. Asses the impact of long-term NIV

METHODS: Observational study with consecutive inclusion of obese patients with AHRF treated with NIV from February 2008 to June 2011. Obesity: BMI>30kg/m; AHRF: pH<7.35 and PaCO2> 45mmHg. Treatment: NIV started in general or respiratory wards and emergency department

RESULTS: N= 196;(171 females); Age:75±11yr, BMI: 39±7 kg/m; FVC:69±22%; FEV1:65±20%; FEV1/FVC:78±11 pH:7,28± 0,7;PaO2 60±26mmHg; PaCO2:76±17mmHg, Glasgow score 13±2 Mean long stay: 11±7 d. Mean follow up: 1.32±0,94yr.; Mortality inside hospital: 9%; Mortality outside hospital: 31%, Global mortality: 40% . Patients discharged with BiPAP: 122; discharged without BiPAP: 56. At the moment of discharge no differences were observed in commorbidities, clinical data and blood gases between patients discharged at home with or without NIV . Patients discharged with NIV had tolerated well an had more total hours of use with BiPAP than those who were discharged wihtout it. Survival rate after discharged: BiPAP group: 992-1176 days; No BiPAP group: 428-696 days (p<0,005). Readmissions 55% (BiPAP) vs 48% (no BiPAP): (p=n.s.). Compliance measured at 3 months of onset and the last recorded was 4,51±3,30 hours and 5,12±3,42 hours daily. No differences in compliance between patients with less or more readmissions were found

CONCLUSIONS: 1. Non invasive ventilation is an effective treatment for patients with obesity-hypoventilation Syndrome and hypercapnic respiratory failure. 2. Patients who received home treatment with NIV survived longer than those who didn't. This forces us to review NIV at treatment at discharge.

CLINICAL IMPLICATIONS: NIV is an effective treatment for OHS with ARF, and will increase survival rate in an stable condition.

DISCLOSURE: The following authors have nothing to disclose: Concepcion Romero, Jesús Sánchez, Virginia Almadana, Ana Gómez-Bastero, Patricia Guerrero, Agustin Valido, Jose María Benítez, Teodoro Montemayor

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