Coppola S, Radovanovic D, Pozzi T, Danzo F, Rocco C, Lazzaroni G, Santus P, Chiumello D. Non-invasive respiratory support in elderly hospitalized patients.
Expert Rev Respir Med 2024;
18:789-804. [PMID:
39267448 DOI:
10.1080/17476348.2024.2404696]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 09/01/2024] [Accepted: 09/11/2024] [Indexed: 09/17/2024]
Abstract
INTRODUCTION
The proportion of elderly people among hospitalized patients is rapidly growing. Between 7% to 25% of ICU patients are aged 85 and over and noninvasive respiratory support is often offered to avoid the risks of invasive mechanical ventilation or in patients with a 'do-not-intubate' order. However, while noninvasive respiratory support has been extensively studied in the general population, there is limited data available on its efficacy in elderly patients with ARF.
AREAS COVERED
PubMed/Medline, Web of Science, Scopus and Embase online databases were searched for studies that assessed clinical efficacy of high flow nasal cannula, continuous positive airway pressure and noninvasive ventilation in patients ≥ 65 years old with acute de novo ARF, showing that short to mid-term benefits provided by noninvasive respiratory support in elderly patients in terms of reduction of mechanical ventilation risk and mortality are similar to younger patients, if adjusted for the severity of comorbidities and respiratory failure.
EXPERT OPINION
Noninvasive support strategies can represent an effective opportunity in elderly patients with ARF, especially in patients too frail to undergo endotracheal intubation and in whom received or decided for a 'do not intubate' order. Indeed, noninvasive support has a different impact, depending on the setting.
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