Noninvasive ventilation and renal replacement therapy in do-not-intubate order critically ill patients: A brief report.

INTRODUCTION: Multiple organ failure has been considered a contraindication for noninvasive ventilation (NIV).

MATERIALS AND METHODS: We described the outcome of Do-not-Intubate (DNI) patients with acute respiratory failure, treated with NIV and, subsequently, necessitating renal replacement therapy (RRT).

RESULTS AND DISCUSSION: Seven patients admitted to our Respiratory Intensive Care Unit, developed Acute Kidney Injury (AKI) during NIV treatment and received RRT for 12.8 ± 8 days together with NIV. All the patients but one, discontinued renal support because they regained a satisfactory urinary output; nevertheless mortality rate was high (71%).

CONCLUSION: Our data suggest that RRT could be feasible together with NIV. RRT was associated with an acute improvement in renal function but did not modify the mortality rate.