RT Journal Article SR Electronic T1 Does Noninvasive Ventilation Delivery in the Ward Provide Early Effective Ventilation? JF Respiratory Care FD American Association for Respiratory Care SP respcare.03294 DO 10.4187/respcare.03294 A1 Carlo Olivieri A1 Luca Carenzo A1 Gian Luca Vignazia A1 Mauro Campanini A1 Mario Pirisi A1 Francesco Della Corte A1 Paolo Navalesi YR 2014 UL http://rc.rcjournal.com/content/early/2014/10/28/respcare.03294.abstract AB BACKGROUND: Although noninvasive ventilation (NIV) is increasingly used in general wards, limited information exists about its ability to provide effective ventilation in this setting. We aim to evaluate NIV delivered in the ward by assessing (1) overall time of application and occurrence of adverse events and (2) differences between daytime and nighttime NIV application. METHODS: We studied subjects with hypercapnic acute hypercapnic respiratory failure not fulfilling strict criteria for ICU admission, and excluded those who interrupted NIV prior to 48 h. Time spent on NIV, presence and extent of air leaks, and occurrence of desaturations were assessed for the overall study period, and compared between daytime and nighttime. RESULTS: We enrolled 42 subjects, 25 of whom received NIV for at least 48 h and were included in the data analysis. NIV was successful for 20 subjects, who did not reach criteria for ICU admission. Both PaCO2 and pH significantly improved on average after 2 h and at the end of the study period. NIV was applied for 64.5% of the overall study period and had absent or compensated air leaks for 62.3% of the overall 48-h period. NIV was applied for 55.8% of daytime and for 79.3% of nighttime (P < .01). Effective NIV application was significantly longer overnight (76.9%) than during daytime (53.2%) (P < .01). CONCLUSIONS: In selected subjects with hypercapnic acute respiratory failure not fulfilling criteria for ICU admission, the application of NIV in the ward is feasible; in addition, NIV can be safely administered overnight.