Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (19)

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (19)There are few data on the amount of time spent by ICU teams with patients classically intubated and mechanically ventilated that we could use for comparison with the amount of extra work caused by acute NPPV; however, we know that stable ICU patients, assessed by TISS and APACHE 221 scores of 19.0 ± 6.7 and 11.5 ±6.0, respectively, require 10.2 ±1.4 hours of nursing work during a 24-hour period (ie, a nurse/patient ratio of 0.43); unstable and more critically ill patients (TISS of 36.6 ±3.3; APACHE 2 of 16.0 ± 2.7) necessitate 26.6 ± 1.4 hours of nursing work per 24 hours (ie, a nurse/patient ratio >1.0; here 1.11).

In our study the patients receiving acute NPPV “consumed,” just for the NPPV procedures supervision and without considering any other aspect of their treatment (like basic nursing, drug and food delivery, etc), the following nurse/patient ratios: 0.17 and 0.18, respectively, for “restrictive-success” and “obstructive-failure” groups. These ratios, computed with the data shown in Table 4, are very close in both groups of patients, because the “restrictive-success” group needed less supervision by ICU nurses but tolerated NPPV longer during the day, whereas the reverse situation occurred in “obstructive-failure” group.

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