Clinical review: Noninvasive ventilation in the clinical setting--experience from the past 10 years.
This brief review analyses the progress of noninvasive ventilation (NIV) over the last decade. NIV has gained the dignity of first line intervention for acute exacerbation of chronic obstructive pulmonary disease, assuring reduction of the intubation rate, rate of infection and mortality. Despite positive results, NIV still remains controversial as a treatment for acute hypoxemic respiratory failure, largely due to the different pathophysiology of hypoxemia. The infection rate reduction effect achieved by NIV application is crucial for immunocompromised patients for whom the endotracheal intubation represents a high risk. Improvements in skills acquired with experience over time progressively allowed successful treatment of more severe patients.
Antonelli
Massimo
M
Unità Operativa di Rianimazione e Terapia Intensiva, Istituto di Anestesia e Rianimazione, Policlinico Universitario A Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy. m.antonelli@rm.unicatt.it
Pennisi
Mariano Alberto
MA
Montini
Luca
L
D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods; D012131:Respiratory Insufficiency / Q000628:therapy*