Dept of Internal and Specialistic Medicine, Section of Respiratory Diseases, University of Catania, Catania, Italy.
Eur Respir J. 2010 Aug;36(2):362-9. doi: 10.1183/09031936.00123509. Epub 2010 Jan 14.
Although noninvasive ventilation (NIV) is becoming very popular, little is known about its pattern of clinical and technical utilisation in different environments. We conducted a web-based survey in Europe to identify the perceived pattern of NIV utilisation and the reason for choosing a specific ventilator and interface type in four common clinical scenarios: acute hypercapnic respiratory failure (AHRF), cardiogenic pulmonary oedema (CPE), de novo hypoxic respiratory failure and weaning/post-extubation failure (W/PE). A response was obtained from 272 (51.3%) out of 530 selected European physicians involved in NIV practice. The NIV utilisation rate was higher for pulmonologists than intensivists/anesthesiologists (p<0.05). The most common indication for all the physicians was AHRF (48%). Physicians were more likely to use NIV dedicated ventilator in AHRF and CPE and an intensive care unit (ICU) ventilator with NIV module in de novo hypoxic respiratory failure and W/PE, mainly because of the possibility of using the double circuit and inspiratory oxygen fraction control. Overall, the oro-nasal mask was the most frequently used interface, irrespective of clinical scenarios. The use of NIV in Europe is generally relatively high, especially among pulmonologists and in AHRF. Dedicated NIV ventilators and ICU ventilators with NIV modules are preferably in AHRF and in de novo hypoxic respiratory failure, respectively, together with oro-nasal masks.
尽管无创通气(NIV)越来越受欢迎,但对于其在不同环境中的临床和技术应用模式却知之甚少。我们在欧洲进行了一项基于网络的调查,以确定在四种常见临床情况下(急性高碳酸血症性呼吸衰竭(AHRF)、心源性肺水肿(CPE)、新发低氧性呼吸衰竭和脱机/拔管失败(W/PE)),NIV 应用的感知模式和选择特定呼吸机和接口类型的原因。我们从参与 NIV 实践的 530 名选定欧洲医生中获得了 272 名(51.3%)的回复。使用 NIV 的医生中,肺病专家比重症监护医师/麻醉师多(p<0.05)。所有医生最常见的适应症是 AHRF(48%)。医生在 AHRF 和 CPE 中更倾向于使用专用 NIV 呼吸机,在新发低氧性呼吸衰竭和 W/PE 中更倾向于使用具有 NIV 模块的重症监护室(ICU)呼吸机,主要是因为可以使用双回路和吸气氧分数控制。总体而言,无论临床情况如何,口鼻面罩都是最常用的接口。NIV 在欧洲的使用通常相对较高,尤其是在肺病专家和 AHRF 中。专用 NIV 呼吸机和具有 NIV 模块的 ICU 呼吸机分别在 AHRF 和新发低氧性呼吸衰竭中更受欢迎,同时还使用口鼻面罩。