RT Journal Article
SR Electronic
T1 Noninvasive Ventilatory Support for Acute Hypercapnic Respiratory Failure
JF Respiratory Care
FD American Association for Respiratory Care
SP 647
OP 657
DO 10.4187/respcare.06931
VO 64
IS 6
A1 Nicholas S Hill
A1 Giulia Spoletini
A1 Gregory Schumaker
A1 Erik Garpestad
YR 2019
UL http://rc.rcjournal.com/content/64/6/647.abstract
AB Noninvasive ventilation is well established as the ventilatory modality of first choice to treat acute or acute-on-chronic hypercapnic respiratory failure in patients with COPD by improving dyspnea and gas exchange, avoiding the need for intubation, and reducing morbidity and mortality rates. Noninvasive ventilation also offers benefit for patients with COPD and with accompanying pneumonia or with hypercapnic respiratory failure in postextubation, postoperative, and do not intubate settings. Noninvasive ventilation, in addition, offers benefit in other forms of acute hypercapnic respiratory failure, including those caused by asthma, cystic fibrosis, and obesity hypoventilation. A newer form of noninvasive ventilatory assistance, high-flow nasal cannula, has emerged in recent years as a technique to not only oxygenate effectively but also to improve ventilatory efficiency and reduce the work of breathing in patients with severe COPD. Results of recent studies indicate that high-flow nasal cannula therapy can benefit some patients with acute hypercapnic respiratory failure, either instead of or in combination with noninvasive ventilation, but more study is needed.