British Thoracic Society: National adult non-invasive ventilation audit 2019 (19 July 2020)

Summary

The British Thoracic Society has published the results of their 2019 national audit of acute non-Invasive ventilation (NIV) in adult patients in NHS hospitals.  

Data were collected in 2019, before the pandemic, and the audit did not look at things such as pandemic preparedness or numbers of NIV hardware available, but at the quality of the service provided.

The audit analysed data provided from over 150 hospitals, for a total of over 3500 patient records, and looked for adherence to our quality standards in the provision of the service.

Content

Some key findings from the audit:

• Inpatient mortality was 26%. It has reduced from 34% in 2013 and represents the first time that mortality has improved since the first BTS audit in 2010.
• Compared to the last audit, an increased proportion of patients treated with acute non-invasive ventilation (NIV) had COPD, the indication with the strongest evidence. We saw a decreased proportion of patients who were treated with NIV despite no clearly documented indication. This suggests improved patient selection in line with the evidence base for NIV.
• 50% of patients treated with NIV started NIV treatment within 60 minutes of the blood gas that defined the need for NIV. Clinician responses indicate a reduced perception of treatment delay in comparison to prior audits.
• Acute NIV was successful in resolving respiratory acidaemia for 76% of patients treated, in comparison to 69% in the last audit (2013).
• Only 74% of organisations reported that they have sufficient capacity to deliver the routine acute NIV service.
• Only 52% of organisations had a nursing lead and 34% had a physiotherapy lead for their acute NIV service.