The Role of Invasive Ventilation in Exacerbations of Chronic Obstructive Pulmonary Disease Causing Respiratory Failure.

2006 ◽  
Vol 5 (3) ◽  
pp. 86-90
Author(s):  
Cristopher Kosky ◽  
◽  
Charles Turton ◽  

Acute hypercapnic respiratory failure in chronic obstructive pulmonary disease can usually be managed initially with medical treatment and non- invasive ventilation. In circumstances where non- invasive ventilation cannot be used or has failed, intubation and invasive ventilation may be lifesaving. The outcome of patients with an exacerbation of COPD requiring invasive ventilation is better than often thought, with a hospital survival of 70-89%. Decisions regarding invasive ventilation made by physicians and patients with COPD are unpredictable and vary with the individual. This article reviews the role of invasive ventilation in exacerbations of COPD to assist decision making.

2019 ◽  
Vol 15 (2) ◽  
pp. 120-132 ◽  
Author(s):  
Cosei Valentin-Caius ◽  
Borcea Corina-Ioana ◽  
Zaharie Ana-Maria ◽  
Mihaltan Florin-Dumitru ◽  
Deleanu Oana-Claudia

The benefit of non-invasive ventilation (NIV) in stable chronic obstructive pulmonary disease (COPD) remains controversial. However, there is increasingly more evidence of NIV efficiency, especially high-flow NIV. This review presents the old and the new evidence of NIV effectiveness in stable COPD, considering pathophysiological arguments for NIV in COPD. Guidelines, randomized controlled trials (RCTs) and crossover studies included in review and metaanalysis based on patient-reported outcomes (PROs) have been analyzed. The role of NIV in rehabilitation and in palliative care and the role of telemedicine in relation with NIV are still up for debate. Challenges in choosing the right device and the optimal mode of ventilation still exist. There are also discussions on the criteria for patient inclusion and on how to meet them. More studies are needed to determine the ideal candidate for chronic NIV and to explain all the benefits of using NIV.


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