Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 6

Long-term survival in elderly patients with a do-not-intubate order treated with noninvasive mechanical ventilation

Authors Scarpazza P, Incorvaia C, Amboni P, di Franco G, Raschi S, Usai P, Bernareggi M, Bonacina C, Melacini C, Cattaneo R, Bencini S, Pravettoni C, Riario-Sforza GG, Passalacqua G, Casali W

Published 26 April 2011 Volume 2011:6 Pages 253—257

DOI https://doi.org/10.2147/COPD.S18501

Review by Single-blind

Peer reviewer comments 3

Paolo Scarpazza1, Cristoforo Incorvaia2, Paolo Amboni3, Giuseppe di Franco1, Stefania Raschi1, Pierfranco Usai1, Monica Bernareggi1, Cristiano Bonacina1, Chiara Melacini1, Roberta Cattaneo1, Serena Bencini1, Chiara Pravettoni2, Gian Galeazzo Riario-Sforza2, Gianni Passalacqua4, Walter Casali1
1Divisione di Broncopneumotisiologia, Ospedale Civile, Vimercate, Italy; 2Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy; 3Clinical Chemistry Laboratory, Ospedali Riuniti, Bergamo, Italy; 4Allergy and Respiratory Diseases, University Of Genoa, Genoa, Italy

Background: Noninvasive mechanical ventilation (NIMV) is an effective tool in treating patients with acute respiratory failure (ARF), since it reduces both the need for endotracheal intubation and the mortality in comparison with nonventilated patients. A particular issue is represented by the outcome of NIMV in patients referred to the emergency department for ARF and with a do-not-intubate (DNI) status because of advanced age or excessively critical conditions. This study evaluated long-term survival in a group of elderly patients with acute hypercapnic ARF who had a DNI order and who were successfully treated by NIMV.
Methods: The population consisted of 54 patients with a favorable outcome after NIMV for ARF. They were followed up for 3 years by regular control visits, with at least one visit every 4 months, or as needed according to the patient’s condition. Of these, 31 continued NIMV at home and 23 were on long-term oxygen therapy (LTOT) alone.
Results: A total of 16 of the 52 patients had not survived at the 1-year follow-up, and another eight patients died during the 3-year observation, with an overall mortality rate of 30.8% after 1 year and 46.2% after 3 years. Comparing patients who continued NIMV at home with those who were on LTOT alone, 9 of the 29 patients on home NIMV died (6 after 1 year and 3 after 3 years) and 15 of the 23 patients on LTOT alone died (10 after 1 year and 5 after 3 years).
Conclusion: These results show that elderly patients with ARF successfully treated by NIMV following a DNI order have a satisfactory long-term survival.

Keywords: COPD, acute respiratory failure, mortality rate, respiratory failure

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Striving for optimal bronchodilation: focus on olodaterol

Incorvaia C, Montagni M, Makri E, Riario-Sforza GG, Ridolo E

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:439-444

Published Date: 1 March 2016

New combinations in the treatment of COPD: rationale for aclidinium–formoterol

Incorvaia C, Montagni M, Makri E, Ridolo E

Therapeutics and Clinical Risk Management 2016, 12:209-215

Published Date: 15 February 2016

Omalizumab, an anti-immunoglobulin E antibody: state of the art

Incorvaia C, Mauro M, Russello M, Formigoni C, Riario-Sforza GG, Ridolo E

Drug Design, Development and Therapy 2014, 8:197-207

Published Date: 7 February 2014

Shrinking the room for invasive ventilation in hypercapnic respiratory failure

Scarpazza P, Incorvaia C, Melacini C, Cattaneo R, Bonacina C, Riario-Sforza GG, Casali W

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:135-137

Published Date: 15 March 2013

Requirements for acquiring a high-quality house dust mite extract for allergen immunotherapy

Frati F, Incorvaia C, David M, Scurati S, Seta S, Padua G, Cattaneo E, Cavaliere C, Di Rienzo A, Dell'Albani I, Puccinelli P

Drug Design, Development and Therapy 2012, 6:117-123

Published Date: 18 May 2012

Seroprevalence of IgG anti-Toxocara species antibodies in a population of patients with suspected allergy

Qualizza R, Incorvaia C, Grande R, Makri E, Allegra L

International Journal of General Medicine 2011, 4:783-787

Published Date: 22 November 2011

The current role of sublingual immunotherapy in the treatment of allergic rhinitis in adults and children

Cristoforo Incorvaia, Simonetta Masieri, Silvia Scurati, et al

Journal of Asthma and Allergy 2011, 4:13-17

Published Date: 20 February 2011

Development of a sublingual allergy vaccine for grass pollinosis

Franco Frati, Silvia Scurati, Paola Puccinelli, et al

Drug Design, Development and Therapy 2010, 4:99-105

Published Date: 17 June 2010

Adherence issues related to sublingual immunotherapy as perceived by allergists

Silvia Scurati, Franco Frati, Gianni Passalacqua, et al

Patient Preference and Adherence 2010, 4:141-145

Published Date: 15 June 2010

Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study

Gian Galeazzo Riario-Sforza, Cristoforo Incorvaia, Fulvia Paterniti, et al

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:315-319

Published Date: 21 August 2009

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Topical diclofenac in the treatment of osteoarthritis of the knee

Niklas Schuelert, Fiona A Russell, Jason J McDougall

Orthopedic Research and Reviews 2011, 3:1-8

Published Date: 6 February 2011

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010