Noninvasive Positive Pressure Ventilation in Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease

摘要: Noninvasive positive pressure ventilation (NPPV) has reemerged as an effective strategy for reducing morbidity and mortality associated with acute exacerbations of chronic obstructive pulmonary disease (COPD). During respiratory failure, dynamic hyperinflation, intrinsic PEEP, increased airway resistance result in a mechanical workload that exceeds inspiratory muscle capacity. NPPV provides augmentation alveolar rest. Observational, cohort, and, more recently, randomized controlled trials have demonstrated the ability to decrease need endotracheal intubation complications mortality. performs better COPD patients without significant comorbid illness. It should be initiated during if arterial pH is less than 7.35 or patient severely distressed. Pressure support (10–20 cmH2O) via face mask likely optimal technique when successful, results rapid clinical improvement.