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Review
. 2000;4(1):15-22.
doi: 10.1186/cc645. Epub 2000 Jan 24.

Noninvasive positive pressure ventilation as treatment for acute respiratory failure in critically ill patients

M Antonelli  1 , G Conti
Affiliations
Review

Noninvasive positive pressure ventilation as treatment for acute respiratory failure in critically ill patients

M Antonelli et al. Crit Care. 2000.

Abstract

Our current state of knowledge on noninvasive positive pressure ventilation (NPPV) and technical aspects are discussed in the present review. In patients with chronic obstructive pulmonary disease, NPPV can be considered a valid therapeutic option to prevent endotracheal intubation. Evidence suggests that, before eventual endotracheal intubation, NPPV should be considered as first-line intervention in the early phases of acute exacerbation of chronic obstructive pulmonary disease. Small randomized and non-randomized studies on the application of NPPV in patients with acute hypoxaemic respiratory failure showed promising results, with reduction in complications such as sinusitis and ventilator-associated pneumonia, and in the duration of intensive care unit stay. The conventional use of NPPV in hypoxaemic acute respiratory failure still remains controversial, however. Large randomized studies are still needed before extensive clinical application in this condition.

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Figures

Figure 1
Figure 1
Patient undergoing noninvasive positive pressure ventilation. The face mask (FM), with its soft inflatable cushion (IC), is connected to the mechanical ventilator (not shown) through a catheter mount (CM), with a heat-moisture exchanger (HME) included in the respiratory circuit. The face mask is secured with elastic straps (ES).
Figure 2
Figure 2
Fiberoptic bronchoscopy during noninvasive positive pressure ventilation. The patient is connected to the ventilator via a face mask (FM) secured with elastic straps (ES). The bronchoscope is passed through a seal adapter (SA), in order to allow mechanical ventilation. The arrow indicates the optical instruments advanced into the nose.
See this image and copyright information in PMC

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