• Jun Duan, Linfu Bai, Lintong Zhou, Xiaoli Han, Lei Jiang, and Shicong Huang.
• Department of Respiratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
• BMJ Open. 2018 Dec 4; 8 (12): e019271.

ObjectiveTo report the resource use, characteristics and outcomes of patients with prolonged non-invasive ventilation (NIV).DesignA single-centre observational study.SettingAn intensive care unit of a teaching hospital.ParticipantsPatients who only received NIV because of acute respiratory failure were enrolled. Prolonged NIV was defined as subjects who received NIV ≥14 days. A total of 1539 subjects were enrolled in this study; 69 (4.5%) underwent prolonged NIV.Main Outcome MeasuresPredictors of prolonged NIV and hospital mortality.ResultsThe rate of do-not-intubate (DNI) orders was 9.1% (140/1539). At the beginning of NIV, a DNI order (OR 3.95, 95% CI 2.25 to 6.95) and pH ≥7.35 (2.20, 1.27 to 3.82) were independently associated with prolonged NIV. At days 1 and 7 of NIV, heart rate (1.01 (1.00 to 1.03) and 1.02 (1.00 to 1.03], respectively) and PaO2/FiO2<150 (2.19 (1.25 to 3.85) and 2.05 (1.04 to 4.04], respectively) were other independent risk factors for prolonged NIV. When patients who died after starting NIV but prior to 14 days were excluded, the association was strengthened. Regarding resource use, 77.1% of subjects received NIV<7 days and only accounted for 47.0% of NIV-days. However, 18.4% of subjects received NIV 7-13.9 days and accounted for 33.4% of NIV-days, 2.9% of subjects received NIV 14-20.9 days and accounted for 9.5% of NIV-days, and 1.6% of subjects received NIV≥21 days and accounted for 10.1% of NIV-days.ConclusionsOur results indicate the resource use, characteristics and outcomes of a prolonged NIV population with a relatively high proportion of DNI orders. Subjects with prolonged NIV make up a high proportion of NIV-days and are at high risk for in-hospital mortality.© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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