A Review Of The Quality Of Care Provided To Patients Receiving Acute Non-Invasive Ventilation

This report focuses on the quality of acute non-invasive ventilation clinical care, for patients aged 16 years or older who are admitted to hospital | National Confidential Enquiry into Patient Outcome and Death 

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Whilst this is a report looking at the care provided to patients receiving acute non- invasive ventilation (NIV), it must be noted that the most common condition that NIV is  used for in hospital is chronic obstructive pulmonary disease (COPD). COPD accounts for around 25% of deaths from lung disease, is the fifth biggest killer disease in the UK and with around 115,000 emergency hospital admissions per year is the second most common reason for hospital admission.

Approximately 20% of patients with COPD present to hospital in acidotic ventilatory failure (elevated carbon dioxide, CO2 ). Once CO2 levels have started to rise, a small
further reduction in breathing will lead to a larger rise in CO2 levels and worsening of acidosis. This leads to a downward spiral and eventually, coma and death. Rapid access to treatment as soon as possible after respiratory acidosis develops is therefore important. NIV can provide this support by using a mask or similar device to attach a
ventilator to the patient.

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