The use of extracorporeal carbon dioxide removal to avoid intubation in patients failing non-invasive ventilation – a cost analysis

BMC Anesthesiology

Research Article

Hilmar Burchardi¹  Markus Engel²  Stephan Braune³  Stefan Kluge³  Axel Nierhaus³  Maria Metschke³  Simone Rosseau⁴  Henning Ebelt⁵ 

[1] Bovenden, Germany;Department of Cardiology and Intensive Care, Klinikum Bogenhausen, Munich, Germany;Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;Department of Internal Medicine, Infectious Diseases and Respiratory Medicine, Charité-Universitaetsmedizin Berlin, Berlin, Germany;Department of Medicine III, University of Halle (Saale), Halle, Germany;

关键词: Extracorporeal;    Carbon dioxide removal;    Mechanical ventilation;    Cost analysis;    Treatment costs;   

DOI  :  10.1186/s12871-015-0139-0

 received in 2015-07-05, accepted in 2015-10-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundTo evaluate the economic implications of the pre-emptive use of extracorporeal carbon dioxide removal (ECCO2R) to avoid invasive mechanical ventilation (IMV) in patients with hypercapnic ventilatory insufficiency failing non-invasive ventilation (NIV).MethodsRetrospective ancillary cost analysis of data extracted from a recently published multicentre case–control-study (n = 42) on the use of arterio-venous ECCO2R to avoid IMV in patients with acute on chronic ventilatory failure. Cost calculations were based on average daily treatment costs for intensive care unit (ICU) and normal medical wards as well as on the specific costs of the ECCO2R system.ResultsIn the group treated with ECCO2R IMV was avoided in 90 % of cases and mean hospital length of stay (LOS) was shorter than in the matched control group treated with IMV (23.0 vs. 42.0 days). The overall average hospital treatment costs did not differ between the two groups (41.134 vs. 39.366 €, p = 0.8). A subgroup analysis of patients with chronic obstructive pulmonary disease (COPD) revealed significantly lower median ICU length of stay (11.0 vs. 35.0 days), hospital length of stay (17.5 vs. 51.5 days) and treatment costs for the ECCO2R group (19.610 vs. 46.552 €, p = 0.01).ConclusionsAdditional costs for the use of arterio-venous ECCO2R to avoid IMV in patients with acute-on-chronic ventilatory insufficiency failing NIV may be offset by a cost reducing effect of a shorter length of ICU and hospital stay.

【 授权许可】

CC BY   
© Braune et al. 2015