International Journal of Chronic Obstructive Pulmonary Disease
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Non-invasive ventilation in exacerbations of COPD
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Authors: Nicolino Ambrosino, Guido Vagheggini
Published Date January 2007
Volume 2007:2(4) Pages 471 - 476
Nicolino Ambrosino, Guido Vagheggini
Pulmonary Unit. Cardio-Thoracic Department, University Hospital Pisa, Italy; Internal Medicine Unit. S. M. Maddalena General Hospital, Volterra, Italy
Abstract: Randomized controlled trials have confirmed the evidence and helped to define when and where non invasive mechanical ventilation (NIV) should be the first line treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Noninvasive ventilation has its best indication in moderate-to-severe respiratory acidosis in patients with AECOPD. For this indication, studies conducted in ICU, in wards and in accident and emergency departments confirmed its effectiveness in preventing endotracheal intubation and reducing mortality. The skill of the health care team promotes proper NIV utilization and improves the patient outcome. Patients with severe acidosis or with altered levels of consciousness due to hypercapnic acute respiratory failure are exposed to high risk of NIV failure. In these patients a NIV trial may be attempted in closely monitored clinical settings where prompt endotracheal intubation may be assured.
Keywords: non-invasive positive pressure ventilation, COPD, acute respiratory failure
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