Purpose of the Study: Data regarding the use of noninvasive ventilation (NIV) for treatment of acute respiratory failure (ARF) among patients with noncystic fibrosis (CF) bronchiectasis are limited. We intend to describe our experience with NIV use in this setting.
Methodology: This was a retrospective study which included 99 patients with bronchiectasis and ARF who required either NIV or invasive mechanical ventilation (IMV).
Results: NIV was started as the primary modality of ventilatory support in 81 (66.3%) patients. Fifty-three (65.4%) patients were managed successfully with NIV. Twenty-eight (34.56%) patients failed NIV and required endotracheal intubation. Reasons for NIV failure were worsening or nonimprovement of ventilatory or oxygenation parameters (n = 15), hypotension (n = 6), worsening of sensorium (n = 3), and intolerance (n = 4). None of the patients failed NIV due to excessive respiratory secretions. The rate of correction of arterial blood gases was comparable between NIV and IMV groups. The total duration of stay (median [interquartile range] days) in hospital was comparable between patients treated with NIV and IMV (8 [7–10] vs. 11 [5–11]; P = 0.99), respectively. The mortality rate between NIV and IMV groups were statistically comparable (8.64% vs. 16.6%; P = 0.08). High APACHE score at admission was associated with NIV failure (odd's ratio [95% confidence interval]: 1.21 (1.07–1.38)].
Conclusions: NIV is feasible for management of ARF with non-CF bronchiectasis. High APACHE may predict NIV failure among these patients.
Bonavita J, Naidich DP. Imaging of bronchiectasis. Clin Chest Med 2012;33:233-48.
Dodd JD, Lavelle LP, Fabre A, Brady D. Imaging in cystic fibrosis and non-cystic fibrosis bronchiectasis. Semin Respir Crit Care Med 2015;36:194-206.
Barker AF, Bardana EJ Jr. Bronchiectasis: Update of an orphan disease. Am Rev Respir Dis 1988;137:969-78.
Bilton D. Update on non-cystic fibrosis bronchiectasis. Curr Opin Pulm Med 2008;14:595-9.
Gao YH, Guan WJ, Liu SX, Wang L, Cui JJ, Chen RC, et al. Aetiology of bronchiectasis in adults: A systematic literature review. Respirology 2016;21:1376-83.
Seitz AE, Olivier KN, Steiner CA, Montes de Oca R, Holland SM, Prevots DR, et al. Trends and burden of bronchiectasis-associated hospitalizations in the United States, 1993-2006. Chest 2010;138:944-9.
Ringshausen FC, de Roux A, Pletz MW, Hämäläinen N, Welte T, Rademacher J, et al. Bronchiectasis-associated hospitalizations in Germany, 2005-2011: A population-based study of disease burden and trends. PLoS One 2013;8:e71109.
Alzeer AH, Masood M, Basha SJ, Shaik SA. Survival of bronchiectatic patients with respiratory failure in ICU. BMC Pulm Med 2007;7:17.
Agarwal R, Gupta R, Aggarwal AN, Gupta D. Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs. other causes: Effectiveness and predictors of failure in a respiratory ICU in North India. Int J Chron Obstruct Pulmon Dis 2008;3:737-43.
Bello G, De Pascale G, Antonelli M. Noninvasive ventilation. Clin Chest Med 2016;37:711-21.
Garpestad E, Brennan J, Hill NS. Noninvasive ventilation for critical care. Chest 2007;132:711-20.
Phua J, Ang YL, See KC, Mukhopadhyay A, Santiago EA, Dela Pena EG, et al. Noninvasive and invasive ventilation in acute respiratory failure associated with bronchiectasis. Intensive Care Med 2010;36:638-47.
Perera PL, Screaton NJ. Radiological features of bronchiectasis. Eur Respir Monogr 2011;52:44-67.
Society BRIGoNiC-BT. The Use of Non-Invasive Ventilation in the Management of Patients with Chronic Obstructive Pulmonary Disease Admitted to Hospital with Acute Type II Respiratory Failure (With Particular Reference to Bilevel Positive Pressure Ventilation); 2008. Availabe from: https://www.brit-thoracicorguk/document-library/clinical-information/niv/niv-guidelines/btsrcpics-guideline-on-niv-in-copd/. [Last accessed on 2017 Jun 29].
Gacouin A, Jouneau S, Letheulle J, Kerjouan M, Bouju P, Fillatre P, et al. Trends in prevalence and prognosis in subjects with acute chronic respiratory failure treated with noninvasive and/or invasive ventilation. Respir Care 2015;60:210-8.
Walaszek M, Kosiarska A, Gniadek A, Kolpa M, Wolk Z, Dobros W, et al. The risk factors for hospital-acquired pneumonia in the Intensive Care Unit. Przeglad epidemiologiczny 2016;70:15-20, 107-110.
Pierson DJ. Indications for mechanical ventilation in adults with acute respiratory failure. Respir Care 2002;47:249-62.
Peñuelas O, Frutos-Vivar F, Fernández C, Anzueto A, Epstein SK, Apezteguía C, et al. Characteristics and outcomes of ventilated patients according to time to liberation from mechanical ventilation. Am J Respir Crit Care Med 2011;184:430-7.
Tan SS, Bakker J, Hoogendoorn ME, Kapila A, Martin J, Pezzi A, et al. Direct cost analysis of Intensive Care Unit stay in four European countries: Applying a standardized costing methodology. Value Health 2012;15:81-6.
Lightowler JV, Wedzicha JA, Elliott MW, Ram FS. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ 2003;326:185.
Corrêa TD, Sanches PR, de Morais LC, Scarin FC, Silva E, Barbas CS, et al. Performance of noninvasive ventilation in acute respiratory failure in critically ill patients: A prospective, observational, cohort study. BMC Pulm Med 2015;15:144.