Utility of non-invasive mechanical ventilation in critically ill patients with exacerbated COPD. Systematic review
DOI:
https://doi.org/10.56294/sctconf2024944Keywords:
Noninvasive Ventilation, Endotracheal Intubation, Pulmonary Disease, Chronic Obstructive, Oxygen Inhalation Therapy, HypercapniaAbstract
Background: non-invasive mechanical ventilation is a useful ventilatory support method for patients with acute respiratory failure or exacerbation of chronic obstructive pulmonary disease mediated by different mechanisms. It helps to reduce airflow resistance and facilitates lung expansion, reducing respiratory muscle fatigue. This allows the patient to breathe more efficiently. By providing positive pressure into the airways, it helps to open the collapsed alveoli and lower airways improving gas exchange. As a consequence, oxygenation enhances. Additionally, by increasing air flow, it helps to eliminate carbon dioxide accumulated in the lungs. It reduces respiratory stress by relieving the feeling of shortness of breath as well as excessive respiratory work, reducing anxiety and stress associated with respiratory distress. Importantly, the decision to use non-invasive ventilation as an alternative to endotracheal intubation should be based on a careful evaluation of the patient and continuous monitoring of their response to the treatment. Not all patients are suitable candidates for non-invasive ventilation and in some cases endotracheal intubation may be necessary to ensure adequate ventilation.
Method: a systematic review was carried out.
Results: 6 articles that met the criteria were reviewed, the number of patients included was 552,23 % (127 patients) were hospitalized in the general ward and 77 % (425 patients) in the Intensive Care Unit, of the total patients. 83,51 % received treatment with non-invasive ventilation, 11,77 % oxygen therapy and 4,71 % endotracheal intubation upon admission. 5,61 % of the total patients required endotracheal intubation during the course of their hospitalization.
Conclusion: in selected patients, Non-invasive ventilation reduces the rate of endotracheal intubation, infectious complications, hospital stay and relapsed. When appropriately used from its implementation until its withdrawal once the respiratory failure is solved, it has a beneficial impact on the patient as well as the economic burden by reducing healhcare cost
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