Non-Invasive Ventilation in the Elderly at Emergency Department: Epidemiological Data and Results

Abstract

Introduction: Non-invasive ventilation (NIV) could be a good alternative in elderly people with acute respiratory failure (ARF), to procure them a respiratory support while avoiding as much as possible the complications of invasive ventilation. Methods: This is an observational retrospective study conducted at the emergency department (ED) of a tertiary care, university-based teaching hospital. Data of elderly patients (≥ 65 years) admitted to ED between January 2017 and April 2018 for ARF and requiring NIV were collected and analyzed using SPSS 22 software. Results: Sixty six patients (≥ 65 years) requiring NIV for acute respiratory failure (ARF) were included. The mean age was 76 years (± 7), the median Charlson index was 5. Acute respiratory failure was related to acute heart failure in 68%, acute exacerbation of chronic obstructive pulmonary disease in 53% and pneumonia in 39% of cases. Forty eight percent had more than one etiologic diagnosis. Hypercapnic acute respiratory failure was observed in 61%. On initiation of NIV, the average pH was 7.31 (± 0.11) and PaCO2 56 mmHg (± 21), After NIV, the average pH was 7.38 (± 0.11) and PaCO2 53 mmHg (± 26). Improvement of pH was significant (p < 0.05). 61% of patients were discharged at home, 9% were admitted to intensive care unit. Invasive ventilation was performed in 4%, of which 23% died. Success of NIV was observed in 68% of patients. Conclusion: NIV can be of a great interest in elderly people. Our study showed that it can be used successfully in the studied settings.