Role of noninvasive ventilation in elderly patients with hypercapnic respiratory failure

Clin Ter. 2012;163(1):e47-52.


The effectiveness of non-invasive ventilation (NIV) in treating patients with acute respiratory failure (ARF) is showed by its ability to diminish the recurrence to endotracheal intubation (ETI), the occurrence of ETI-associated lung infections as well as related mortality. A specific issue is the outcome of NIV in patients referring to Emergency Department for ARF who receive a do-not-intubate (DNI) order because of too critical conditions or advanced age. Recent data show that elderly patients (mean age 81 years) with ARF who have a DNI order can be successfully treated by NIV, as demonstrated by a survival rate of 83%. The positive outcome was confirmed by a subsequent 3-year observation, that demonstrated an overall survival rate of 54%. These findings clearly suggest to treat by NIV elderly patients also in presence of a DNI order.

Publication types

  • Review

MeSH terms

  • Advance Directive Adherence
  • Advance Directives
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Case-Control Studies
  • Cohort Studies
  • Contraindications
  • Emergencies
  • Humans
  • Hypercapnia / complications
  • Hypercapnia / therapy*
  • Intubation, Intratracheal
  • Patient Acceptance of Health Care
  • Positive-Pressure Respiration* / methods
  • Prospective Studies
  • Respiratory Insufficiency / metabolism
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy*
  • Survival Rate
  • Treatment Refusal