[Noninvasive ventilation in respiratory insufficiency. Indications--methods--limits].
Non-invasive ventilation (NIV) supports alveolar ventilation and represents an alternative to conventional invasive mechanical ventilation in suitable cases of respiratory failure. It usually takes the form of positive airway pressure ventilation, either continuous (CPAP) or bilevel positive airway pressure (BiPAP), applied via a nasal or face mask. NIV is capable of increasing arterial oxygen saturation and lowering pCO2. Initial controlled studies involving patients with severe COLD have shown that, in comparison with conventional invasive ventilation, NIV significantly reduces morbidity, mortality and the duration of hospitalisation. It has also been used successfully to treat respiratory failure due to other pulmonary disorders, neuromuscular diseases, during weaning from invasive ventilation, and as "bridging" therapy in patients awaiting lung transplantation. However, further studies on indications and technique are needed to define more clearly the role of NIV in the clinical setting. For the time being, therefore, NIV should be considered to be experimental, and conventional mechanical ventilation should always be available on standby.
Hamm
H
H
Abteilung Pneumologie, Medizinische Klinik, Universität Freiburg/Br.
Luterbacher
T
T
Matthys
H
H
D006801:Humans; D008173:Lung Diseases, Obstructive / Q000209:etiology / Q000628:therapy; D008397:Masks; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D011379:Prognosis; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*