Use of non-invasive ventilation (NIV) in patients with acute respiratory failure in emergency departments: a systematized review
The aim of this study si to revise the use of non-invasive ventilation (NIV) in patients with acute respiratory failure in emergency departments. A systematized database review will be carried out by the search of articles attending the presented subject following a unique approach; restricting the results to findings in the last five years either in Spanish or English. A research performed in paediatric population concluded that the early management of acute respiratory failure and the use of high flow nasal cannulae reduced the hospitalization period and the referral to specialized hospitals, and gave more independence to regional hospitals in its management; reducing, therefore, the number of patients needing the implementation of invasive procedures. With respect to patients with exacerbations of the chronic obstructive pulmonary disease (COPD) and its early management in the prehospital care, an increase in the mortality in those patients who were exposed to high flow compared to the conventional oxygen therapy was observed. Following the results of a meta-analysis, no benefits were found in the use of high flow nasal cannulae opposed to the conventional therapy or NIV in the emergency departments, in terms of need for intubations, failures in the treatment, hospitalization and mortality.The data are inconclusive in all the studies analyzed and there is no agreement between the different authors. There is a scarce piece of bibliography regarding the use of NIV in the emergency departments due to the fact that the majority of the research are focused on the use of this techniques in intensive care units. In conclussion, there is a diversity in the results of the revised articles according to the use of NIV in the emergency departments.