Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema

作者：Rialp Cervera G; del Castillo Blanco A; Perez Aizcorreta O; Parra Morais L

来源：Medicina Intensiva, 2014, 38(2): 111-121.

DOI：10.1016/j.medin.2012.09.007

• Chronic obstructive pulmonary disease
• Congestive hart failure
• Noninvasive positive-pressure ventilation
• Continuous positive airway pressure
• Mortality

Noninvasive ventilation (NIV) with conventional therapy improves the outcome of patients with acute respiratory failure due to hypercapnic decompensation of chronic obstructive pulmonary disease (COPD) or acute cardiogenic pulmonary edema (ACPE). This review summarizes the main effects of NIV in these pathologies. In COPD, NIV improves gas exchange and symptoms, reducing the need for endotracheal intubation, hospital mortality and hospital stay compared with conventional oxygen therapy. NIV may also avoid reintubation and may decrease the length of invasive mechanical ventilation. In ACPE, NIV accelerates the remission of symptoms and the normalization of blood gas parameters, reduces the need for endotracheat intubation, and is associated with a trend towards lesser mortality, without increasing the incidence of myocardial infarction. The ventilation modality used in ACPE does not affect the patient prognosis.

• 出版日期2014-3