Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications

Annals of Intensive Care

Table 2 NIPPV and intubation demographics

Characteristics	Primary intubation ( n = 110)	Failed NIPPV ( n = 125)	p value
Reason for NIPPV
Hypoxemia	-	55.9% (66)	-
Hypercapnea	-	25.4% (30)	-
Work of breathing	-	8.5% (10)	-
Other	-	10.2% (12)	-
Duration of NIPPV	-		-
Mean/median (h)	-	12.3/5.8	-
Reason for intubation^a			<0.001
Airway protection	26.4% (29)	6.4% (8)
Respiratory failure	62.7% (69)	91.2% (114)
Patient control	1.8% (2)	0.8% (1)
Hemodynamic instability	5.5% (6)	0.8% (1)
Severe metabolic acidosis	3.6% (4)	0.8% (1)
Method of intubation			0.25
RSI	73.6% (81)	69.6% (87)
SED	25.5% (28)	30.4% (38)
OTI	0.9% (1)	0.0% (0)
Operator PGY level			0.27
1	12.8% (14)	7.2% (9)
2	21.1% (23)	16.0% (20)
3	14.7% (16)	12.8% (16)
4	21.1% (23)	29.6% (37)
5	16.5% (18)	24.8% (31)
6	11.9% (13)	8.8% (11)
Attending	1.8% (2)	0.8% (1)

^aReason for intubation includes airway protection in which the patient is unable to protect the airway from aspiration of secretions; respiratory failure, which includes all etiology of respiratory failure; patient control which is defined as agitation, danger to self, or to facilitate evaluation/procedures; hemodynamic instability, which is defined as shock and severe metabolic acidosis.
NIPPV, noninvasive positive-pressure ventilation; RSI, rapid sequence intubation; SED, sedation-only intubation; OTI, orotracheal intubation without medication; PGY postgraduate year.