Background: Noninvasive ventilation as well established in treatment of chronic respiratory failure. Many announcements and our own experience give evidence that this method of treatment is useful for patients with acute respiratory failure too. Also the actual situation of our health system requires increasing attention to financial points of view.
Patients and method: We analyzed a number of 185 patients who needed mechanical ventilation in our intensive care unit in 1995. 80 of these 185 needed mechanical ventilation due to pulmonary and cardiopulmonary diseases (e. g. cardiac failure, exacerbation of chronic obstructive lung disease, pneumonia and status asthmaticus). 61 received invasive, 19 noninvasive ventilation.
Results: Nineteen of 61 patients with invasive and 1 of 19 with noninvasive ventilation died. The mean duration of ventilation was 8.9 (1-50) days in the invasive ventilated group and 2.9 (1-8) days in the noninvasive ventilated group. A cost reduction of nearly 10000 Marks per patient can be calculated, using noninvasive ventilation due to the shorter duration of treatment.
Conclusion: So noninvasive ventilation is a cost reducing and gentle alternative compared to conventional invasive mechanical ventilation for many patients with acute respiratory failure. It is also practicable in regional hospitals. Further investigation is needed to specify those groups of patients who receive the most benefit from noninvasive ventilation.