{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:48:33Z","timestamp":1767167313246,"version":"build-2238731810"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Canadian Respiratory Journal"],"published-print":{"date-parts":[[2021,12,21]]},"abstract":"<jats:p>\n                    Background. The use of ward-based noninvasive ventilation (NIV) for acute hypercapnic respiratory failure (AHRF) unrelated to chronic obstructive pulmonary disease (COPD) remains controversial. This study evaluated the outcomes and failure rates associated with NIV application in the ward-based setting for patients with AHRF unrelated to COPD. Methods. A multicentre, retrospective cohort study of patients with AHRF unrelated to COPD was conducted. COPD was not the main reason for hospital admission, treated with ward-based NIV between February 2004 and December 2018. All AHRF patients were eligible; exclusion criteria comprised COPD patients, age\u2009&lt;\u200918 years, pre-NIV pH\u2009&lt;\u20097.35, or a lack of pre-NIV blood gas. In-hospital mortality was the primary outcome; univariable and multivariable models were constructed. The obesity-related AHRF group included patients with AHRF due to obesity hypoventilation syndrome (OHS), and the non-obesity-related AHRF group included patients with AHRF due to pneumonia, bronchiectasis, neuromuscular disease, or fluid overload. Results. In total, 479 patients were included in the analysis; 80.2% of patients survived to hospital discharge. Obesity-related AHRF was the indication for NIV in 39.2% of all episodes and was the aetiology with the highest rate of survival to hospital discharge (93.1%). In the multivariable analysis, factors associated with a higher risk of in-hospital mortality were increased age (odds ratio, 95% CI: 1.034, 1.017\u20131.051,\n                    <jats:inline-formula>\n                      <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                      <\/a:math>\n                    <\/jats:inline-formula>\n                    ) and pneumonia on admission (5.313, 2.326\u201312.131,\n                    <jats:inline-formula>\n                      <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                      <\/c:math>\n                    <\/jats:inline-formula>\n                    ). In the obesity-related AHRF group, pre-NIV pH\u2009&lt;\u20097.15 was associated with significantly increased in-hospital mortality (7.800, 1.843\u201333.013,\n                    <jats:inline-formula>\n                      <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.005<\/e:mn>\n                      <\/e:math>\n                    <\/jats:inline-formula>\n                    ); however, a pre-NIV pH 7.15\u20137.25 was not associated with increased in-hospital mortality (2.035, 0.523\u20137.915,\n                    <jats:inline-formula>\n                      <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.305<\/g:mn>\n                      <\/g:math>\n                    <\/jats:inline-formula>\n                    ). Conclusion. Pre-NIV pH and age have been identified as important predictors of surviving ward-based NIV treatment. Moreover, these data support the use of NIV in ward-based settings for obesity-related AHRF patients with pre-NIV pH thresholds down to 7.15. However, future controlled trials are required to confirm the effectiveness of NIV use outside critical care settings for obesity-related AHRF.\n                  <\/jats:p>","DOI":"10.1155\/2021\/4835536","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T17:50:10Z","timestamp":1640109010000},"page":"1-7","source":"Crossref","is-referenced-by-count":4,"title":["Ward-Based Noninvasive Ventilation for Acute Hypercapnic Respiratory Failure Unrelated to Chronic Obstructive Pulmonary Disease"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9181-1700","authenticated-orcid":true,"given":"Bandar M.","family":"Faqihi","sequence":"first","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"},{"name":"Respiratory Therapy Department, College of Applied Medical Sciences, King Saud Bin Abdul Aziz University for Health Sciences, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-8362","authenticated-orcid":true,"given":"Dhruv","family":"Parekh","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"},{"name":"Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0150-2283","authenticated-orcid":true,"given":"Samuel P.","family":"Trethewey","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Morlet","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4466-0660","authenticated-orcid":true,"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-3254","authenticated-orcid":true,"given":"Alice M.","family":"Turner","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK"},{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD004104.pub3","article-title":"Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease","volume":"1","author":"F. 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