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Critical Care |

Impact of a Respiratory High-dependency Care Unit Dependent on a Pneumology Department in Noninvasive Ventilation

Alejandro Peralta, MD; Lucia Gimeno, MD; Cristina Oliver, MD; Alicia Binimelis, MD; Belen Nuñez, MD; Miguel Carrera, PhD; Monica de la Peña, MD; Ernest Sala, PhD
Author and Funding Information

Pneumology, Hospital Son Espases, Palma de Mallorca, Spain


Chest. 2014;145(3_MeetingAbstracts):207E. doi:10.1378/chest.1921933
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Abstract

SESSION TITLE: Critical Care

SESSION TYPE: Slide Presentation

PRESENTED ON: Saturday, March 22, 2014 at 04:15 PM - 05:15 PM

PURPOSE: Non invasive ventilation (NIV) is a standardized treatment that has proven beneficial effects in different respiratory and cardiologic diseases. The increasing development of NIV has enabled chest physicians to assist more complex patients and stimulate the setting-up of specials units (Respiratory High-Dependency Care Units [RHDCU]). These units are specialized in severe respiratory patients who need NIV and monitoring. The aim of this study was to evaluate the impact of a RHDCU in non-invasive ventilated patients.

METHODS: Prospective study that compared the role of a RHDCU dependent on a Pneumology department with respect to a conventional ward, in NIV patients admitted in Hospital Son Espases between July 2011 and June 2012. Cardiac failure patients and domiciliary NIV were excluded.

RESULTS: 88 patients were included, 46 admitted in RHDCU and 42 in conventional ward. The patients admitted in RHDCU, with respect to ward patients showed, respectively, worse pulmonary function (FEV1 post-bd. 37±15% pred. vs. 52±27% pred), higher severity index (APACHE: 21±6 vs. 13±5) and lower hospital stays (12±7 vs. 17±13 days) (p<0.05). Furthermore, the patients admitted to the RHDCU had a lower pH (7.25 ±0.07 vs. 7.28±0.06) and less NIV duration (5.4±3.4 vs 6.5±7.3 days) compared with the patients in conventional wards, with no statistical significance. However, we found no differences in mortality and readmissions between both groups.

CONCLUSIONS: A RHDCU dependent on a Pneumology department allows the physician: 1) to apply NIV in more severe patients; 2) to decrease the hospital stay in patients treated with NIV; and, 3) all, with no increase in mortality or readmissions.

CLINICAL IMPLICATIONS: Respiratory High-Dependency Care Units dependent on a Pneumology department afford the possibility to treat more severe patients with a higher level of monitoring and allow to identify therapeutic failures prematurely.

DISCLOSURE: The following authors have nothing to disclose: Alejandro Peralta, Lucia Gimeno, Cristina Oliver, Alicia Binimelis, Belen Nuñez, Miguel Carrera, Monica de la Peña, Ernest Sala

No Product/Research Disclosure Information


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