In this large retrospective analysis of patients hospitalized with acute COPD exacerbations with respiratory failure, the use of noninvasive ventilation increased from 14% to 16% from 2006 to 2008, but variation in use between hospitals was great (ranging from 0 to 100%, with a median of 11%). Noninvasive ventilation was associated with better outcomes than invasive ventilation, including lower inpatient mortality (risk ratio 0.54, CI 0.50 to 0.59), shorter LOS (-3.2 days, CI -3.4 to -2.9), lower hospital charges (-$35,012, CI -$36,848 to -$33,176), and fewer iatrogenic pneumothorax (0.05% vs 0.5%, p<0.001). Noninvasive ventilation is probably underutilized, and associated with better outcomes compared to invasive ventilation, in patients with acute COPD with respiratory failure (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.