Non-invasive Ventilation in an Elderly Population Admitted to a Respiratory Monitoring Unit: Causes, Complications and One-year Evolution

• Published in: Archivos de bronconeumología (English ed.) Vol. 48; no. 10; pp. 349 - 354
• Main Authors: Segrelles Calvo, Gonzalo, Zamora García, Enrique, Girón Moreno, Rosa, Vázquez Espinosa, Emma, Gómez Punter, Rosa Mar, Fernandes Vasconcelos, Gilda, Valenzuela, Claudia, Ancochea Bermúdez, Julio
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España 01.10.2012
• Subjects: Acidosis, Respiratory - blood; Acidosis, Respiratory - drug therapy; Acidosis, Respiratory - etiology; Acidosis, Respiratory - therapy; Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; Ancianos; Chronic obstructive pulmonary disease; Combined Modality Therapy; Disease Management; Elderly; Enfermedad pulmonar obstructiva crónica; Female; Follow-Up Studies; Heart failure; Heart Failure - complications; Hospital Mortality; Humans; Insuficiencia cardíaca; Internal Medicine; Kidney Failure, Chronic - complications; Male; Non-invasive mechanical ventilation; Noninvasive Ventilation - utilization; Oxygen - blood; Oxygen Inhalation Therapy; Patient Readmission - statistics & numerical data; Prospective Studies; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary/Respiratory; Respiratory Care Units - statistics & numerical data; Respiratory Monitoring Unit; Spain - epidemiology; Tertiary Care Centers - statistics & numerical data; Unidad de monitorización respiratoria; Vasoconstrictor Agents - therapeutic use; Ventilación mecánica no invasiva; Spain; Heart failure; Unidad de monitorización respiratoria; Ventilación mecánica no invasiva; Respiratory Monitoring Unit; Insuficiencia cardíaca; Chronic obstructive pulmonary disease; Ancianos; Non-invasive mechanical ventilation; Elderly; Enfermedad pulmonar obstructiva crónica
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/j.arbr.2012.07.011

Abstract Objective To determine the usefulness of NIV in elderly patients (≥75) admitted to a Respiratory Monitoring Unit (RMU) during hospitalization and 1 year later in comparison with the results from the younger age group (<75). Materials and methods Ours is a prospective observational study carried out at the Hospital Universitario La Princesa (Madrid). We recruited all patients who were ≥75 years old and were admitted to our RMU during the period 2008–2009 with respiratory acidosis (pH<7.35 and PaCO2 >45 mmHg) requiring NIV. We gathered data for basic variables as well as sociodemographics, history of previous pathologies, reason for hospitalization and severity, analysis upon admission and the evolution of blood gases at the start of NIV (within the first hour and after 24 h), complications and evolution at the 1-year follow-up. Results Mean age of the sample was 80.6. The Charlson index was 3.27. About half of the patients had some limitation for performing daily activities. The main reasons for admission were chronic obstructive pulmonary disease (COPD) exacerbation and heart failure (HF). There were complications in 36% of the cases (11 renal failure and 6 atrial fibrillation). The survival rate at the 1-year follow-up was 63.21%. Conclusions NIV is a good alternative in elderly patients admitted to the hospital with respiratory acidosis. We did not detect differences in mortality during admission between the 2 groups. The elderly patients were more frequently re-admitted than the younger group in the 6–12 months after hospital discharge. This could be due to their poorer functional state after hospitalization requiring NIV.