Noninvasive positive-pressure ventilation in patients with chronic obstructive pulmonary disease and acute respiratory failure

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7 Citations (Scopus)

Abstract

A large body of literature, including six randomized studies, supports applying noninvasive positive-pressure ventilation via mask in patients with chronic obstructive pulmonary disease and acute respiratory failure as an early intervention to prevent deterioration to the point of requiring endotracheal intubation or as an alternative to endotracheal intubation in those with the most severe impairment in gas exchange. Correctly applying noninvasive positive-pressure ventilation results in rapid improvement in the pathophysiology of acute respiratory failure and correction of arterial blood gas abnormalities. A reduction in Pco2 or an increase in pH within 1 to 2 hours of noninvasive positive-pressure ventilation predicts a sustained improvement in gas exchange and shorter duration of ventilatory support. Under adequate monitoring, the risk of postponing endotracheal intubation in patients in whom noninvasive positive-pressure ventilation fails (20% to 30%) is minimal.

Original languageEnglish (US)
Pages (from-to)35-46
Number of pages12
JournalCurrent Opinion in Critical Care
Volume2
Issue number1
DOIs
StatePublished - Jan 1 1996

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Positive-Pressure Respiration
Respiratory Insufficiency
Chronic Obstructive Pulmonary Disease
Intratracheal Intubation
Gases
Masks

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

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abstract = "A large body of literature, including six randomized studies, supports applying noninvasive positive-pressure ventilation via mask in patients with chronic obstructive pulmonary disease and acute respiratory failure as an early intervention to prevent deterioration to the point of requiring endotracheal intubation or as an alternative to endotracheal intubation in those with the most severe impairment in gas exchange. Correctly applying noninvasive positive-pressure ventilation results in rapid improvement in the pathophysiology of acute respiratory failure and correction of arterial blood gas abnormalities. A reduction in Pco2 or an increase in pH within 1 to 2 hours of noninvasive positive-pressure ventilation predicts a sustained improvement in gas exchange and shorter duration of ventilatory support. Under adequate monitoring, the risk of postponing endotracheal intubation in patients in whom noninvasive positive-pressure ventilation fails (20{\%} to 30{\%}) is minimal.",
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