Use and performance of non-invasive ventilation in Internal Medicine ward: a real-life study

Controlled trials demonstrated efficacy and safety of non-invasive ventilation (NIV) in treatment of acute respiratory failure, initially in Intensive Care Units, then in other care settings (semi-intensive care units, emergency departments, and also in the wards, more often pneumological ones). Few studies have been published about NIV in Italian wards of Internal Medicine with full self-management of NIV by internists in a normal ward setting . We performed a prospective real-life study about the use of NIV in Internal Medicine ward devoid of a critical area of semi-intensive therapy, with the aim of confirming, in this setting, the effectiveness of NIV. During a period of 13 months, 42 patients with hypercapnic respiratory failure of different etiology and acidosis (pH 7.25), neither according to the acute physiology and chronic health evaluation II score and the national early warning score, but the modified early warning score only showed statistically significant difference with lower values in the success group: 2.82±1.57 vs 4.13±1.46 (P<0.05). NIV has proven to be effective and safe in Internal Medicine ward.