Thursday, March 20, 2014

Review of noninvasive ventilation in the treatment of hypercapnic respiratory failure

This review is from the journal Breathe.

Acute exacerbation of COPD is the best established indication for NIV in the category of hypercapnic respiratory failure. But as evident from the review these indications are expanding and contraindications (particularly depressed level of consciousness) are shrinking, or becoming relative as opposed to absolute. One concern I had in this otherwise excellent review was mention of neuromuscular respiratory disease (without specification any given type and without mention of Guillain-Barre) as an indication for NIV. While I suppose, as more and more experience is gained with NIV in neuromuscular respiratory disease it will emerge as an alternative in some situations my last read on GB was that early invasive ventilation was the modality of choice for certain respiratory situations even before the onset of hypercapnia.

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