Abstract
Our current state of knowledge on noninvasive positive pressure ventilation (NPPV) and technical aspects are discussed in the present review. In patients with chronic obstructive pulmonary disease, NPPV can be considered a valid therapeutic option to prevent endotracheal intubation. Evidence suggests that, before eventual endotracheal intubation, NPPV should be considered as first-line intervention in the early phases of acute exacerbation of chronic obstructive pulmonary disease. Small randomized and non-randomized studies on the application of NPPV in patients with acute hypoxaemic respiratory failure showed promising results, with reduction in complications such as sinusitis and ventilator-associated pneumonia, and in the duration of intensive care unit stay. The conventional use of NPPV in hypoxaemic acute respiratory failure still remains controversial, however. Large randomized studies are still needed before extensive clinical application in this condition.
Highlights
Mechanical ventilation through an endotracheal tube is a well established, accepted and life-saving procedure for patients with acute respiratory failure (ARF)
In chronic obstructive pulmonary disease (COPD) patients, Noninvasive positive pressure ventilation (NPPV) can be considered as a therapeutic option to prevent endotracheal intubation and to deliver artificial ventilatory support [6,9]
A trial of NPPV should be always considered if a COPD patient is observed to be in the early phase of respiratory failure
Summary
Mechanical ventilation through an endotracheal tube is a well established, accepted and life-saving procedure for patients with acute respiratory failure (ARF). A further randomized study on hypercapnic and hypoxaemic ARF PSV and pressure control ventilation were used through [36] suggested that early application of NPPV facilitates face masks in four patients affected by cardiogenic and improvement, decreases the need for invasive mechanical noncardiogenic pulmonary oedema, with good results in ventilation, and decreases the duration of hospitalization. Tion of COPD, noninvasive PSV during weaning reduced were successfully ventilated under continuous positive weaning time (P = 0.021), shortened the duration of stay airway pressure, avoided intubation and had a favourable in the intensive care unit (P = 0.005), decreased the inci- prognosis, mainly in the cardiogenic pulmonary oedema dence of nosocomial pneumonia, and improved 60-day group, without side effects. Even though good cooperation of the patient and thorough monitoring of vital functions are essential, the technique appears very promising for application on a large scale in immunocompromized patients
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