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• W2947371517 abstract "Introduction and objectives Severe community acquired pneumonia (sCAP) constitutes an increasing proportion of adult intensive care unit (ICU) admissions with an associated high morbidity and mortality.1 Non-invasive ventilation (NIV) is a component of the standard of care for many causes of acute hypercapnic respiratory failure (AHRF).2 However, NIV use in AHRF secondary to sCAP remains controversial. This study investigates outcomes of sCAP patients managed with NIV in ICU. Methods Retrospective, observational study of consecutive patients admitted to general ICU with sCAP from January 2016 to May 2017. Severe CAP defined as CAP requiring critical care management. Adequate trial of NIV classified as NIV for minimum 2 hours. NIV cohort was sub-divided into three sub-sets for analysis; NIV as ceiling of care, NIV failure requiring invasive mechanical ventilation (IMV) and NIV success, thus avoiding IMV. Results Total of 205 sCAP patients identified, of which 114 (56%) were managed with NIV and 46 (22%) immediate IMV. NIV success cohort had the shortest ICU (4 days) and hospital (13 days) stay and 100% ICU survival rate. NIV failure cohort had the highest rate of multi-organ support and required an average 11 days intubation, longer than the immediate IMV cohort (9 days). Importantly, patients failing NIV had comparable survival rates as those requiring immediate IMV (hospital survival 66% vs 67% and 90 day survival 63% vs 65% respectively). Conclusion Successful NIV treatment in sCAP patients is linked with reduction in length of stay and improved survival. However, patients who fail NIV have similar survival rates as those requiring immediate IMV. Therefore, NIV trial in a critical care setting is a valid management tool for AHRF secondary to sCAP but larger, prospective studies are needed to characterise risk-factors to identify patients who may fail NIV management. References Woodhead M, et al. Coomunity-acquired pneumonia on the intensive care unit: Secondary analysis of 17,869 cases in the ICNARC Case Mix Programme Database. Critical Care2006;10(Suppl 2):S1. Davidson AC, et al. BTS/ICS guidelines for the ventilatory management of acute hypercapnic respiratory failure in adults. Thorax2016;71(Suppl 2):1–35." @default.
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• W2947371517 date "2018-12-01" @default.
• W2947371517 modified "2023-09-23" @default.
• W2947371517 title "P208 The use of non-invasive ventilation in patients with community acquired pneumonia admitted to the intensive care unit" @default.
• W2947371517 doi "https://doi.org/10.1136/thorax-2018-212555.365" @default.
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