Noninvasive ventilation in treatment of acute respiratory failure in ICU

In the last years noninvasive ventilation (NIV) is used increasingly worldwide in treatment of acute respiratory failure (ARF). The evidence strongly supports NIV use in patients with ARF, especially for chronic obstructive pulmonary disease (COPD) ex-acerbations and acute cardiogenic pulmo-nary edema. The efficacy of NIV depends on several factors like the experience of medical team, adequate selection of patient and inter-face and appropriate ventilator settings. This is a retrospective analysis of patients with ARF treated by NIV in the medical in-tensive care unit (ICU), University Hospital Sveti Duh, between January 2015 and Janu-ary 2016.Analysis of statistical hospital data showed steady increments in NIV utilization from year 2011 (7%) to 2015 (15.7%). The mean age of studied patients was 69.8 years, 58.3% were male and 41.7% female. Four ma-jor causes for applying NIV were: COPD (41.7%), pneumonia (25%), acute cardio-genic pulmonary edema (19.4%) and other reasons (13.9%). Of 108 patients 93 (86.1%) were successfully treated with NIV and 15 (13.9%) were intubated. A number of randomized clinical trials sup-port the use of NIV in patients with ARF and beside the beneficial role in reducing patients symptoms it showed reduction in morbidity, mortality and length of stay in ICU. Failure rates of NIV still range from 25% to 40%, and optimization of NIV success rates requires careful patient selection and knowledge of proper application and monitoring tech-niques. If a patient fails to improve sufficient-ly, prompt endotracheal intubation should be performed without delay.