Noninvasive ventilation: A survey of practice patterns of its use in India

BACKGROUND AND AIMS: To understand the practice patterns of noninvasive ventilation (NIV) use by Indian physicians. SUBJECTS AND METHODS: Around three thousand physicians from all over India were mailed a questionnaire that could capture the practice patterns of NIV use. RESULTS: Completed responses were received from 648 physicians (21.6%). Majority (n = 469, 72.4%, age 40 ± 9 years, M:F 409:60) use NIV in their clinical practice. NIV was most exclusively being used in the ICU setting (68.4%) and the commonest indication for its use was chronic obstructive pulmonary disease (COPD) (71.4%). A significant number did not report use of a conventional ventilator for NIV support (62%). Oronasal mask was the overwhelming favorite among the sampled physicians (68.2%). In most of the cases, the treating physician initiated NIV (60.8%) and a baseline blood gas analysis was performed in only 71.1% of the cases (315/443). Nasal bridge pressure sores was the commonest complication (64.2%). CONCLUSIONS: NIV is being widely used in clinical practice in India for various indications. COPD is the most common indication for its deployment. There seems to be a marked variability in the patterns relating to actual deployment of NIV, including the site of initiation, protocols for initiation followed, and monitoring of patients.