Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

Methods of noninvasive pressure support ventilation (NIPSV) are not always easy to apply in patients with acute exacerbations of chronic obstructive p ulmonary disease (COPD). The assistance time spent by nurses in relation to ventilatory time was pro spectively studied, when NIPSV was used, in a sequential mode, in COPD pati ents with either acute exacerbations (58 patients, group I) or postextubati on hypercapnic respiratory insufficiency (42 patients, group II) in a medic al intensive care unit. During the first 24 h after enrolment, NIPSV was used for 6.7+/-3.2 h (mean +/-SD) in group I and 5.6+/-3.1 h in group II; the duration of NIPSV sessio ns and the nurse time consumption per session were respectively 47+/-12 and 11+/-7 min in group I, and 46+/-12 and 11+/-6 min in group II. After the f irst 24 h of the study, the duration of NIPSV was 4.7+/-3.2 h.day(-1) in gr oup I and 4.9+/-3.5 h.day(-1) in group II, and the nurse time consumption d ropped significantly: the duration of NIPSV sessions and the nurse time con sumption per session were respectively 44+/-10 and 7+/-4 min in group I, an d 47+/-14 and 7+/-3 min in group Ii, Between the first 24 h and the subsequ ent period of 24 h, the nursing time dropped significantly (98 versus 59 mi n in group I (p<0.05), and 85 versus 52 min in group II (p<0.05)). There wa s no difference in the duration of NIPSV sessions, or in the overall assist ance time per session, between the two groups of patients. In conclusion, the study seems to favour a quite low assistance time spent by nurses in relation to ventilatory time when noninvasive pressure support ventilation is used in chronic obstructive pulmonary disease patients with either acute exacerbations or postextubation hypercapnic respiratory insuf ficiency.