A survey of the practice of non-invasive positive pressure ventilation in emergency department in China / 中华急诊医学杂志

ABSTRACT

Objective To investigate the application of non-invasive positive pressure ventilation in emergency department in China.Methods A questionnaire survey was carried out in the emergency department in China,then the results were analyzed.Results Out of the 317 hospitals,non-invasive ventilators were available in the emergency department in 150 clinics (47.3％).Among them,144 clinics were the tertiary hospitals,and 6 clinics were the secondary hospitals.The leading five causes for NPPV were as followsacute exacerbation of chronic obstructive pulmonary diseases (AECOPD) (29.7％),acute cardiogenic pulmonary edema (23.2％),ventilator weaning (11.2％),acute respiratory distress syndrome (ARDS) (9.0％),and extubation failure (8.7％).The bi-level positive airway pressure (BiPAP) S/T was the most commonly used ventilation mode (51.8％),followed by the continuous positive airway pressure (CPAP)(30.3％) and BiPAP (S)(12.5％).The oronasal mask (73.7％) and the nasal mask (24.2％) were the most favorable interfaces for NPPV.The reasons for NPPV underusing mainly included insufficient training (36.8％),lacking of related knowledge (22.9％),medical teaching staff shortage (21.1％) and poor compliance of patients (11.0％).The main causes of the failure of NPPV were as followspoor tolerance (31.5％),irrational parameters setting (25.6％),unfitness of interface (17.8％),airway secretions (14.7％),and disorders of consciousness (10.4％).Conclusions In China,the types of patients most commonly treated with NPPV in the emergency department are those with AECOPD and acute cardiogenic pulmonary edema.Barriers to popularize the use of NPPV in the emergency department include availability of equipment,physician with familiarity in operating the NPPV,and human resources required for NPPV.