Non-invasive ventilation in palliative care: a systematic review

Area of Science:

• Pulmonology
• Critical Care Medicine
• Geriatric Medicine

Background:

• Aging populations and increased chronic diseases challenge healthcare systems.
• Advances in therapies like non-invasive ventilation (NIV) improve survival rates.
• NIV is a key option for end-stage chronic respiratory failure when intubation is excluded.

Purpose of the Study:

• To review the evidence supporting the use of non-invasive ventilation (NIV) in various end-stage chronic respiratory conditions.
• To synthesize findings on NIV efficacy across different patient populations.

Main Methods:

• Systematic literature search of major medical databases (MEDLINE, EMBASE, etc.) from inception to December 2017.
• Inclusion of various study types from the Cochrane Library and other abstracting services.

Main Results:

• Strong evidence supports NIV for exacerbations of chronic obstructive pulmonary disease (COPD) and end-stage neuromuscular disease.
• Limited evidence supports NIV for end-stage interstitial lung disease and morbid obesity.
• NIV is recommended for palliative care to alleviate dyspnea in cancer patients.

Conclusions:

• Patient-centered decisions regarding NIV are crucial, ideally made before terminal stages.
• Open communication between patients, healthcare professionals, and families is essential for treatment planning.