Highly Accessed Letter

Noninvasive mechanical ventilation for very old patients with limitations of care: is the ICU the most appropriate setting?

Raffaele Scala1* and Antonio Esquinas2

Author Affiliations

1 Respiratory Ward and Respiratory Intensive Care Unit, S. Donato Hospital, ASL 8 Arezzo, Via Nenni 20, 52100 Arezzo, Italy

2 Intensive Care Unit, Hospital Morales Meseguer, Avenida Marqués de Los Velez s/n, 30500, Murcia, Spain

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Critical Care 2012, 16:429 doi:10.1186/cc11352

Published: 7 June 2012

First paragraph (this article has no abstract)

We read with interest the recent article by Schortgen and colleagues [1], who emphasized the role of noninvasive ventilation (NIV) as a 'ceiling' ventilatory treatment within the 'do-not-intubate (DNI) context', which turns out to be the largest indication in octogenarians given their high risk of developing life-threatening complications during invasive ventilation. As underlined by the authors, NIV may be considered a valid option in a wide range of 'DNI-linked' clinical scenarios, ranging from life support to a purely palliative tool [2].