La ventilation non invasive au cours de l'insuffisance respiratoire aiguë

Abstract

Non-invasive ventilation is a ventilatory technique applied to patients in respiratory distress, without the need for endotracheal intubation. In the intensive care unit, the most frequently used interface between the patient and the ventilator is the facial mask. Two ventilatory modes are preferentially used: continuous positive airway pressure (CPAP) and pressure support ventilation. Since the beginning of the years 1990, non-invasive ventilation became the first line ventilatory method during chronic obstructive pulmonary disease acute exacerbations and cardiogenic pulmonary edema. In these indications, the application of non-invasive ventilation showed its effectiveness in term of limitation of the intubation and nosocomial infection rates, as well as mortality. It is currently more and more frequently performed in other indications such as bilateral hypoxemic pneumonia and the postoperative course... In short, non-invasive ventilation has become within a few years an essential therapeutic tool in intensive care.