Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomized controlled trial.

Background Older patients usually receive less invasive and costly hospital care, especially if they meet the criteria for Intensive Care Unit (ICU) admission or have a ‘do not intubate’(DNI) order. Objective: The aim of this randomized, control trial was to assess the effectiveness of non-invasive mechanical ventilation (NIV) vs standard medical therapy (SMT) in reducing the need of intubation, improving survival and reducing respiratory distress in very old patients with acute hypercapnic respiratory failure.Methods: Eighty-two patients aged >75 years (mean age 81.3±3.5 years) with acute hypercapnic respiratory failure were randomized to receive NIV or SMT Results: primary outcome was the need of meeting the intubation criteria (ETIc);secondary outcomes were: 12-months mortality “history”; respiratory rate, dyspnea score, and arterial blood gases.Meeting the ETIc was lower in the NIV in comparison with SMT group (7.3 vs. 63.4% of patients, respectively; p