• Javier Jacob, María Arranz, Mariona Sancho Ramoneda, Àngels Lopez, Mª Carmen Navarro Sáez, José Ramón Cousiño Chao, Xavier López Altimiras, Francesc López I Vengut, Olivia García Trallero, José Zorrilla, Antonio German, Jaume Farré Cerdà, Eva Lista, and Grupo de trabajo VMNI-SoCMUE.
• Servicio de Urgencias, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
• Emergencias. 2017 Feb 1; 29 (1): 33-38.

ObjectivesTo study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality.Material And MethodsProspective analysis of a consecutive multicenter cohort of patients who were treated with NIV between February and March 2015. The study was undertaken in emergency medical services in Catalonia and 8 Catalan hospital emergency departments. We collected information during the acute episode and on discharge, as well as data describing the patients' condition when stable. The dependent variable was all-cause hospital mortality.ResultsWe studied 184 acute episodes requiring NIV, in the prehospital setting in 25 cases (13.6%) and in the hospital in 159 (86.4%). The most common scenario was acute heart failure (AHF) (38.0%). The second most common was chronic obstructive pulmonary disease (COPD) (34.2%). In most cases, NIV was discontinued in the emergency department. Mortality was 7.5% during prehospital care and 21.4% in the hospital. Hospital mortality was associated with limiting the use of life support. We detected no significant differences in mortality between the groups of patients with AHF vs COPD.ConclusionThe use of NIV in prehospital and hospital emergency care follows current evidence-based recommendations and is required more often for AHF than for exacerbated COPD. Hospital mortality is high in this context and is associated with frequent limiting of life support.

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