Noninvasive ventilation in the older patient who has acute respiratory failure.
Older patients are at significantly increased risk of acute respiratory failure from multiple causes. Noninvasive positive pressure ventilation has been shown to dramatically improve care of patients with acute respiratory failure. Patient selection is important in all patients being treated with noninvasive positive pressure ventilation but is especially important in older patients. Delirium, confusion, and dementia can lead to difficulty for patients in tolerating this procedure and lead to a worsening respiratory status. The presence of a do-not-intubate order does not necessarily preclude the use of noninvasive positive pressure ventilation, and some patients may derive significant benefit from its use. Overall, noninvasive positive pressure ventilation is a reasonable and justifiable option in the treatment of acute respiratory failure in older patients.
Lunghar
Layola
L
Pulmonary, Critical Care and Sleep Medicine Division, The Center for Sleep Medicine, Tufts University School of Medicine, Tufts-New England Medical Center, 750 Washington Street #257, Boston, MA 02111, USA.
D'Ambrosio
Carolyn M
CM
D000368:Aged; D006801:Humans; D011175:Positive-Pressure Respiration / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome