Noninvasive Positive Airway Pressure Ventilation and Risk of Facial Pressure Ulcers

Noninvasive Positive Airway Pressure Ventilation and Risk of Facial Pressure Ulcers in Patients With Acute Respiratory Failure

To assess risk of skin pressure lesions in patients treated with noninvasive mechanical ventilation.

Noninvasive ventilation improves the outcome of patients with acute respiratory failure; however patient's discomfort may be responsible for up to a fifth of failures. Scant literature exists on NIV-related pressure ulcers and their determinants.

Aim of the study is to seek for determinants, if any, associated with the development of pressure ulcers related to noninvasive ventilation.

Study design: observational. Patients treated with NIV from December 2009 to December 2011 will be analyzed. Main end-points: to seek for variables associated to the development of NIV-related pressure ulcers in patients with acute respiratory failure.

Inclusion Criteria:

• severe dyspnea at rest
• respiratory rate > 30 per minute
• PaO2/FiO2 < 200 (despite oxygen with Venturi with a FiO2 og 0.5)
• use of accessory respiratory muscles
• pH < 7.35 > 7.10

Exclusion Criteria:

• STEMI
• NSTEMI/Unstable angina
• Hemodynamic instability
• Need for immediate endotracheal intubation
• Inability to protect the airways
• Impaired sensorium
• Pulmonary embolism
• Gastrointestinal bleeding
• Hematological malignancy or neoplasms with ECOG performance status > 2