tailieunhanh - Báo cáo y học: "Another step for noninvasive ventilation in chronic obstructive pulmonary disease patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Another step for noninvasive ventilation in chronic obstructive pulmonary disease patients! | Jaber and Chanques Critical Care 2010 14 163 http content 14 3 163 CRITICAL CARE COMMENTARY L__ Another step for noninvasive ventilation in chronic obstructive pulmonary disease patients Samir Jaber and Gerald Chanques See related research by Scala etal. http content 14 2 R80 Abstract The use of noninvasive positive pressure ventilation NPPV in chronic obstructive pulmonary disease COPD patients who are not eligible for the technique because of their incapability to spontaneously eliminate accumulated secretions associated with hypercapnic encephalopathy is not recommended and is often considered a contraindication. In a case-control study an experienced team reported the feasibility and safety of the use of NPPV with early fibreoptic bronchoscopy in selected acutely decompensated COPD patients with hypercapnic encephalopathy and reported the patients inability to spontaneously clear copious secretions. The reported data suggest that this innovative therapeutic may be considered as a potential alternative to endotracheal intubation. For patients with an exacerbation of chronic obstructive pulmonary disease COPD noninvasive positive pressure ventilation NPPV is considered the standard of care 1 and should be available as first-line therapy in any institution that treats acutely ill COPD patients 2 . Most randomised control trials of NPPV for acute respiratory failure however have excluded patients without efficient clearance of secretions 2 . As a matter of a fact the inability to spontaneously remove respiratory secretions has been considered a relative contraindication to applied NPPV in acute respiratory failure especially if the inability occurs in patients with impaired consciousness and depressed cough 2 3 . Few studies have shown that within expert units NPPV is feasible and may be applied with success in Correspondence s-jaber@ Intensive Care Unit Anesthesia and Critical Care Department B Saint Eloi Teaching

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