Noninvasive Home Mechanical Ventilation for Stable Hypercapnic COPD: A Clinical Respiratory Review from Canadian Perspectives.

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM Canadian respiratory journal Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI:10.1155/2023/8691539
Rachel Jen, Colin Ellis, Marta Kaminska, Jeremy Road, Najib Ayas
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Abstract

Acute short-term noninvasive ventilation (NIV) for hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD) has well-established benefits; however, the role of long-term home NIV remains controversial. In the past decade, studies utilizing aggressive NIV settings to maximally reduce carbon dioxide levels (PaCO2) have resulted in several positive clinical trials and led to updated guidelines on home NIV for stable hypercapnic COPD patients. This clinical respiratory review discusses the high-intensity NIV approach, summarizes recent key trials and guidelines pertaining to home NIV in COPD, and considers key clinical questions for future research and application in the Canadian context. With recent evidence and Canadian Thoracic Society (CTS) guidelines supporting the use of NIV in carefully selected COPD patients with persistent daytime hypercapnia, we believe it is time to reconsider our approach.

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无创家庭机械通气治疗稳定型慢性阻塞性肺病:来自加拿大的临床呼吸系统回顾。
急性短期无创通气(NIV)治疗慢性阻塞性肺病(COPD)高碳酸血症性呼吸衰竭具有公认的益处;然而,长期家庭NIV的作用仍然存在争议。在过去的十年里,利用积极的NIV设置来最大限度地降低二氧化碳水平(PaCO2)的研究已经产生了几项积极的临床试验,并更新了稳定的高碳酸血症COPD患者的家庭NIV指南。这篇临床呼吸综述讨论了高强度NIV方法,总结了最近与COPD家庭NIV相关的关键试验和指南,并考虑了未来在加拿大研究和应用的关键临床问题。根据最近的证据和加拿大胸科学会(CTS)的指导方针,支持在精心选择的患有持续性日间高碳酸血症的COPD患者中使用NIV,我们认为是时候重新考虑我们的方法了。
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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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