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NONINVASIVE VENTILATION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

GORDANA PAVLIŠA ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia
ANDRIJA NEKIĆ ; University of Zagreb, School of Medicine, Zagreb, Croatia
HRVOJE PURETIĆ ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb, Croatia
FEĐA DŽUBUR ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia
ANA HEĆIMOVIĆ ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb, Croatia
MATEJA JANKOVIĆ MAKEK ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia
MIROSLAV SAMARŽIJA ; Zagreb University Clinical Hospital Centre, Jordanovac Department for Lung Diseases, Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia

Abstract

Noninvasive ventilation (NIV) refers to positive pressure ventilation that is delivered through a noninvasive interface. It is considered as a standard treatment for patients admitted to hospital with hypercapnic respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease (COPD). NIV improves gas exchange and reduces respiratory muscle work, consequently allowing respiratory muscle recovery. The available evidence establishes that NIV might reduce intubation, morbidity and mortality rates in patients with severe COPD exacerbations. NIV shortens intensive care unit and total hospital lengths of stay. It can be used to facilitate the process of weaning from mechanical ventilation and prevent development of post-extubation respiratory failure. Patients with severe respiratory acidosis or with altered levels of consciousness due to carbon dioxide retention are at a high risk of NIV failure. In these patients, a NIV trial should be attempted in closely monitored clinical conditions where prompt endotracheal intubation may be performed. The benefi ts of long-term NIV management of stable COPD are still controversial. However, implementation of high-intensity NIV has been shown to improve outcomes in this patient group. High-intensity NIV improves gas exchange, lung function, health-related quality of life, exercise tolerance and survival compared to standard care alone. In stable severe COPD, the addition of NIV to a pulmonary rehabilitation program improves outcomes as compared to pulmonary rehabilitation alone. Since NIV provides signifi cant benefi ts in COPD, every physician who is involved in the treatment of these patients should be familiar with this technique.

Keywords

noninvasive ventilation; high-intensity noninvasive ventilation; chronic obstructive pulmonary disease; acute respiratory hypercapnic failure

Hrčak ID:

209069

URI

https://hrcak.srce.hr/209069

Publication date:

18.11.2018.

Article data in other languages: croatian

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