Noninvasive mechanical ventilation in patients with acute respiratory failure

Nabil Abou-Shala, Gianfranco Meduri

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Objectives: a) To describe the introduction of noninvasive means to provide positive-pressure ventilation in acute respiratory failure; b) to describe the physiologic response to noninvasive ventilation; c) to review the current published literature on using noninvasive ventilation in patients with acute hypercapnic end/or hypoxemic respiratory failure; d) to describe the technique of applying mask ventilation and current recommendations for using noninvasive ventilation in patients with acute respiratory failure; and e) to discuss the advantages and disadvantages of noninvasive ventilation. Data Sources: All relevant articles published in the English medical literature from 1988 through August 1994 were retrieved through a MEDLINE search, as well as from the authors' experience. Study Selection: Studies were selected based on the use of positive-pressure mechanical ventilation delivered, using facial or nasal masks in various acute settings of respiratory failure. Data Extraction: The authors extracted all applicable data. Data Synthesis: Studies were analyzed according to the type of respiratory failure (hypercapnic vs. hypoxemic) and the underlying conditions where noninvasive ventilation seemed to be a better alternative. The results were evaluated based on types of masks used and modes of ventilation. Outcome measures were compared based on studies that randomized patients with acute respiratory failure to receive noninvasive ventilation vs. conventional therapy. Complications of noninvasive ventilation, mainly local, were compared with those complications seen with endotracheal intubation in acute respiratory failure patients. Conclusions: Noninvasive ventilation is a safe and effective means of ventilatory support for many patients with acute respiratory failure, particularly those patients with hypercapnic respiratory failure. Noninvasive ventilation is well tolerated, principally because it allows the patient to be in control and to continue verbal communication, and should be strongly considered in managing terminally ill patients with potentially reversible causes of respiratory failure. The duration of mechanical ventilation and its associated complications are significantly decreased in hypercapnic respiratory failure with noninvasive ventilation.

Original languageEnglish (US)
Pages (from-to)705-715
Number of pages11
JournalCritical Care Medicine
Volume24
Issue number4
DOIs
StatePublished - Apr 1996

Fingerprint

Noninvasive Ventilation
Artificial Respiration
Respiratory Insufficiency
Masks
Positive-Pressure Respiration
Terminally Ill
Intratracheal Intubation
Information Storage and Retrieval
Nose
MEDLINE
Ventilation
Communication
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Noninvasive mechanical ventilation in patients with acute respiratory failure. / Abou-Shala, Nabil; Meduri, Gianfranco.

In: Critical Care Medicine, Vol. 24, No. 4, 04.1996, p. 705-715.

Research output: Contribution to journalArticle

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