• Luca Cabrini, Elena Moizo, Elisa Nicelli, Gloria Licini, Stefano Turi, Giovanni Landoni, Paolo Silvani, and Alberto Zangrillo.
• Department of Anesthesia and Intensive Care, Ospedale Istituto Scientifico San Raffaele, Milan, Italy. cabrini.luca@hsr.it
• Resp Care. 2012 May 1;57(5):704-9.

BackgroundNoninvasive ventilation (NIV) is increasingly utilized outside the ICU for patients with acute respiratory failure. However, success and failure risk factors and patient safety aspects have been poorly explored in this setting. So far, no study has evaluated the perspective of the patient, despite the known high relevance of patient participation for NIV success.MethodsWe prospectively interviewed (following a standard questionnaire) the patients successfully treated with NIV for acute respiratory failure outside the ICU. Subjects were interviewed 24-48 hours after NIV suspension.Exclusion CriteriaNIV failure, patient not competent, patient unwilling to participate in the study, patient transferred to the ICU.ResultsForty-five consecutive patients were included in the study. Only 20% participated in the initial setting of NIV parameters. More than 40% reported they never had the possibility to discuss the NIV treatment. Eighty percent reported they were never asked to try another interface. All subjects knew how to call for help, but only one fourth had been trained to remove the mask, and 22% reported not being able at all to remove the mask if needed. One half of the subjects reported having received help immediately when needed, but 15% waited more than 3 min. All subjects reported complications, and 18% reported respiratory worsening while on NIV.ConclusionsSubjects reported a low level of involvement in the initial setting of NIV treatment, low satisfaction about communication with the caring staff, and a suboptimal safety level in case of emergency.

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