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Noninvasive positive-pressure ventilation in chronic obstructive pulmonary disease
1Pomona Valley Hospital Medical Center, Critical Care and Pulmonary Care Continuum, CA 91767, USA.
Current Opinion in Pulmonary Medicine
|June 5, 1998
Summary
Noninvasive positive-pressure ventilation (NIPPV) shows promise for respiratory failure and certain chronic conditions. However, its effectiveness varies by application, patient, and equipment, requiring careful clinical judgment.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Respiratory Therapy
Background:
- Growing interest in noninvasive positive-pressure ventilation (NIPPV) as an alternative to invasive ventilation.
- NIPPV acceptance is high in neuromuscular deficits; evidence in COPD varies by application.
Purpose of the Study:
- To review the clinical implementation and efficacy of NIPPV in various acute and chronic respiratory conditions.
- To assess the evidence supporting NIPPV in acute respiratory failure, postextubation weaning, COPD, overlap syndrome, and nocturnal desaturation.
Main Methods:
- Literature review of clinical studies on NIPPV.
- Analysis of NIPPV applications including acute respiratory failure, weaning, COPD, overlap syndrome, and nocturnal desaturation.
Main Results:
- Some NIPPV applications are well-supported, warranting cautious recommendations.
- Evidence for other applications is conflicting, highlighting variability in outcomes.
- Clinical efficacy depends heavily on equipment, interface, settings, and clinician experience.
Conclusions:
- NIPPV has specific indications and contraindications, but exceptions exist.
- Successful NIPPV implementation requires a blend of scientific knowledge and clinical art.
- Further research is needed to clarify optimal use in diverse patient populations.