Noninvasive Ventilation at the End of Life in U.S. Hospitals

Intensive care admission at the end of life remains common in the U.S. Aggressive interventions, such as invasive mechanical ventilation (IMV), frequently are used to support patients. Numerous studies support use of noninvasive ventilation (NIV) to treat exacerbations of chronic obstructive pulmonary disease (COPD) and congestive heart failure as a palliative measure at the end of life to relieve work of breathing and provide time to address goals of care.

Investigators analyzed data from nearly 2.5 million Medicare beneficiaries who were hospitalized in the last 30 days of life. Sixteen percent of patients received IMV in intensive care, whereas 4% were supported with NIV. During the 17-year period examined, use of NIV increased from 0.8% …