Reversal of Acute Exacerbations of Chronic Obstructive Lung Disease by Inspiratory Assistance with a Face Mask

Brochard, Laurent; Isabey, Daniel; Piquet, J.; Amaro, Piedade; Mancebo, J.; Messadi, A; Brun‐Buisson, Christian; Rauss, Alain; Lemaire, F; Harf, Alain

doi:10.1056/nejm199011293232204

Cited by 614 publications

(299 citation statements)

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“…Initial case series and uncontrolled cohort studies that suggested benefit in selected patients [1][2][3][4][5][6][7][8][9][10][11][12][13] led to many randomized controlled trials (RCTs). Both methods of ventilation have been used in the setting of acute respiratory failure to avoid endotracheal intubation in different patient populations and settings, with variable success.…”

mentioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

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mentioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

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“…In the study of BOTT et al [4], NIPSV was used for 6 days, as for patients in group I in the present study; however, respiratory acidosis was more significant for patients in the present study than in that of BOTT et al [4]. Some authors have previously proposed administering NIPSV discontinuously [1,4,5,20,23,24]. The sequential mode used on the present study is also a discontinuous mode, thus allowing comparison of the present results with those of other studies, with some specificity, i.e.…”

Section: Discussionmentioning

confidence: 49%

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

et al. 2000

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Methods of noninvasive pressure support ventilation (NIPSV) are not always easy to apply in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD).The assistance time spent by nurses in relation to ventilatory time was prospectively studied, when NIPSV was used, in a sequential mode, in COPD patients with either acute exacerbations (58 patients, group I) or postextubation hypercapnic respiratory insufficiency (42 patients, group II) in a medical intensive care unit.During the first 24 h after enrolment, NIPSV was used for 6.7 3.2 h (mean SD) in group I and 5.6 3.1 h in group II; the duration of NIPSV sessions and the nurse time consumption per session were respectively 47 12 and 11 7 min in group I, and 46 12 and 11 6 min in group II. After the first 24 h of the study, the duration of NIPSV was 4.7 3.2 h . day -1 in group I and 4.9 3.5 h . day -1 in group II, and the nurse time consumption dropped significantly: the duration of NIPSV sessions and the nurse time consumption per session were respectively 44 10 and 7 4 min in group I, and 47 14 and 7 3 min in group II. Between the first 24 h and the subsequent period of 24 h, the nursing time dropped significantly (98 versus 59 min in group I (p<0.05), and 85 versus 52 min in group II (p<0.05)). There was no difference in the duration of NIPSV sessions, or in the overall assistance time per session, between the two groups of patients.In conclusion, the study seems to favour a quite low assistance time spent by nurses in relation to ventilatory time when noninvasive pressure support ventilation is used in chronic obstructive pulmonary disease patients with either acute exacerbations or postextubation hypercapnic respiratory insufficiency. Methods of noninvasive pressure support ventilation (NIPSV) are being proposed more and more for patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure [1±6]. NIPSV can avoid the need for endotracheal intubation and its increasingly documented complications [7]. Nevertheless, this method of ventilation requires the presence of nurses familiar with the technique, and this may be time-consuming [3,8]. Moreover, according to certain reports [2, 4, 9, 10], some patients do not tolerate noninvasive ventilatory support, and side-effects of these techniques occur quite frequently [3,11].Three articles have demonstrated that the institution of noninvasive mechanical ventilation is not significantly more time-consuming for personnel than traditional medical therapy [4,12] or invasive mechanical ventilation [13]. However, two of these studies [12,13] were performed in respiratory intensive care units (ICUs) with a specialized activity, and where patient/staff ratios are generally lower than in general ICUs [13]. The authors consider that the problem lies not in comparing the workload linked to utilization of NIPSV with that linked to standard treatment or invasive mechanical ventilation, since it is advisable to use NIPSV to avoid intubation. It is more a question of know...

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“…NIV via face mask or helmet has been the evidence-based treatment of choice in AECOPD patients with hypercapnia for more than 20 yrs [3]. NIV has been shown to improve gas exchange and outcome when compared with IMV.…”

Section: To the Editorsmentioning

confidence: 99%

“…Social deprivation scores were assigned to 1,896 lower super output areas (LSOAs) across Wales (average LSOA population 1,560) [3]. The LSOAs were ranked according to their social deprivation score and categorised into quintiles (I: least deprived; V: most deprived).…”

Section: To the Editorsmentioning

confidence: 99%

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Extracorporeal lung assist might avoid invasive ventilation in exacerbation of COPD: Table 1–

et al. 2012

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Reversal of Acute Exacerbations of Chronic Obstructive Lung Disease by Inspiratory Assistance with a Face Mask

Abstract: Inspiratory positive airway pressure delivered by a face mask can obviate the need for conventional mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease.

Cited by 614 publications

References 24 publications

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

Extracorporeal lung assist might avoid invasive ventilation in exacerbation of COPD: Table 1–

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