ArticleAnnals of the American Thoracic Society2017
Evidence-based Utilization of Noninvasive Ventilation and Patient Outcomes.
Article in Annals of the American Thoracic Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Use of noninvasive positive pressure ventilation in patients admitted to the internal medicine service of a tertiary care hospital.BMC research notes · 2026Article
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- Analgesia and Sedation Use During Noninvasive Ventilation for Acute Respiratory Failure.Critical care medicine · 2024Article
- Article
- Variation in Use of High-Flow Nasal Cannula and Noninvasive Ventilation Among Patients With COVID-19.Respiratory care · 2022Observational
- Characteristics and Risk Factors for Mortality in Critically Ill Patients with COVID-19 Receiving Invasive Mechanical Ventilation: The Experience of a Private Network in Sao Paulo, Brazil.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2022Article
- Mechanical Ventilation and Survival in Patients With Advanced Dementia in Medicare Advantage.Journal of pain and symptom management · 2022Article
- Dying with dementia in Medicare Advantage, Accountable Care Organizations, or traditional Medicare.Journal of the American Geriatrics Society · 2021Article
- Effectiveness and Harms of High-Flow Nasal Oxygen for Acute Respiratory Failure: An Evidence Report for a Clinical Guideline From the American College of Physicians.Annals of internal medicine · 2021Review
- Noninvasive Ventilation in Seriously Ill Older Adults at the End of Life-The Evidence Remains Elusive.JAMA internal medicine · 2021Article
- Noninvasive Ventilation Use in Critically Ill Patients with Acute Asthma Exacerbations.American journal of respiratory and critical care medicine · 2020Article
- Outcome of non-invasive ventilation in COVID-19 critically ill patients: A Retrospective observational Study.Anaesthesia, critical care & pain medicine · 2020Observational
- Mechanical Ventilation in COVID-19: Interpreting the Current Epidemiology.American journal of respiratory and critical care medicine · 2020Article
- Noninvasive Ventilation for Critically Ill Subjects With Acute Respiratory Failure in the Emergency Department.Respiratory care · 2020Article
- ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.Critical care medicine · 2019Article
- Outcomes of Noninvasive Positive Pressure Ventilation in Acute Respiratory Distress Syndrome and Their Predictors: A National Cohort.Critical care research and practice · 2019Article
- Hospital Variation in Renal Replacement Therapy for Sepsis in the United States.Critical care medicine · 2018Article
- Noninvasive ventilation utilization in the Kingdom of Saudi Arabia: Results of a national survey.Annals of thoracic medicineArticle
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
rationaleStrong evidence supports use of noninvasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure (strong evidence conditions [SECs]). Despite unclear benefits of NIV for other causes of acute respiratory failure, utilization for conditions with weaker evidence is increasing, despite evidence demonstrating higher mortality for patients who suffer NIV failure (progression from NIV to invasive mechanical ventilation [IMV])) compared with being treated initially with IMV.
objectivesTo determine the association of hospital variation in evidence-based utilization of NIV with patient outcomes.
methodsUsing the California State Inpatient Database 2011, we identified adult patients who received NIV. Patients were considered to have an SEC for NIV if they had an acute exacerbation of chronic obstructive pulmonary disease or heart failure. We used multivariable hierarchical logistic regression to determine the association between hospital rates of NIV use for SECs and patient risk of NIV failure (need for IMV after NIV).
resultsAmong 22,706 hospitalizations with NIV as the initial ventilatory strategy, 6,820 (30.0%) had SECs. Patients with SECs had lower risk of NIV failure than patients with weak evidence conditions (8.1 vs. 18.2%, P < 0.0001). Regardless of underlying diagnosis, patients admitted to hospitals with greater use of NIV for SECs had lower risk of NIV failure (Quartile 4 vs. Quartile 1 adjusted odds ratio = 0.62; 95% CI = 0.49-0.80). Even patients without an SEC benefited from admission to hospitals that used NIV more often for patients with SECs (Quartile 4 vs. Quartile 1 adjusted odds ratio for NIV failure = 0.68; 95% CI = 0.52-0.88).
conclusionsMost patients who received NIV did not have conditions with strong supporting evidence for its use with wide institutional variation in patient selection for NIV. Surprisingly, we found that all patients, even those without an SEC, benefited from admission to hospitals with greater evidence-based utilization of NIV, suggesting a "hospital effect" that is synergistic with patient selection.
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