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- Title
Noninvasive Ventilatory Support for Acute Hypercapnic Respiratory Failure.
- Authors
Hill, Nicholas S.; Spoletini, Giulia; Schumaker, Gregory; Garpestad, Erik
- Abstract
Noninvasive ventilation is well established as the ventilatory modality of first choice to treat acute or acuteon- chronic hypercapnic respiratory failure in patients with COPD by improving dyspnea and gas exchange, avoiding the need for intubation, and reducing morbidity and mortality rates. Noninvasive ventilation also offers benefit for patients with COPD and with accompanying pneumonia or with hypercapnic respiratory failure in postextubation, postoperative, and do not intubate settings. Noninvasive ventilation, in addition, offers benefit in other forms of acute hypercapnic respiratory failure, including those caused by asthma, cystic fibrosis, and obesity hypoventilation. A newer form of noninvasive ventilatory assistance, high-flow nasal cannula, has emerged in recent years as a technique to not only oxygenate effectively but also to improve ventilatory efficiency and reduce the work of breathing in patients with severe COPD. Results of recent studies indicate that high-flow nasal cannula therapy can benefit some patients with acute hypercapnic respiratory failure, either instead of or in combination with noninvasive ventilation, but more study is needed.
- Subjects
RESPIRATORY insufficiency treatment; HYPERCAPNIA; OBESITY complications; AIRWAY (Anatomy); ARTIFICIAL respiration; ASTHMA; CRITICAL care medicine; CYSTIC fibrosis; OBSTRUCTIVE lung diseases; OXYGEN therapy; TRACHEA intubation; HYPOVENTILATION; CONTINUOUS positive airway pressure; POSITIVE end-expiratory pressure; NASAL cannula; DISEASE complications; THERAPEUTICS
- Publication
Respiratory Care, 2019, Vol 64, Issue 6, p647
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.06931