CMAJ • November 6, 2007; 177 (10). doi:10.1503/cmaj.060147.
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Review

Noninvasive positive-pressure ventilation in acute respiratory failure

Oscar Peñuelas, MD, Fernando Frutos-Vivar, MD and Andrés Esteban, MD PhD

From Intensive Care Service (Peñuelas, Frutos-Vivar, Esteban), Hospital Universitario de Getafe, Madrid, Spain; and Ciber de Enfermedades Respiratorias (Frutos-Vivar, Esteban), Instituto Carlos III, Spain.

Correspondence to: Dr. Andrés Esteban, Intensive Care Unit, Hospital Universitario de Getafe, 28905 Madrid, Spain; fax 34-91-6832095; aesteban{at}ucigetafe.com

Abstract

Noninvasive positive-pressure ventilation is a type of mechanical ventilation that does not require an artificial airway. Studies published in the 1990s that evaluated the efficacy of this technique for the treatment of diseases as chronic obstructive pulmonary disease, congestive heart failure and acute respiratory failure have generalized its use in recent years. Important issues include the selection of the ventilation interface and the type of ventilator. Currently available interfaces include nasal, oronasal and facial masks, mouthpieces and helmets. Comparisons of the available interfaces have not shown one to be clearly superior. Both critical care ventilators and portable ventilators can be used for noninvasive positive-pressure ventilation; however, the choice of ventilator type depends on the patient's condition and therapeutic requirements and on the expertise of the attending staff and the location of care. The best results (decreased need for intubation and decreased mortality) have been reported among patients with exacerbations of chronic obstructive pulmonary disease and cardiogenic pulmonary edema.


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Can. Med. Assoc. J. 2007 177: 1161. [Full Text] [PDF]

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Can. Med. Assoc. J. 2007 177: 1161. [Full Text] [PDF]



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V. Puro MD, F. M. Fusco MD, S. Pittalis MD, S. Lanini MD, and G. Ippolito MD
Noninvasive positive-pressure ventilation
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eLetters:

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Another Look at Noninvasive Positive-Pressure Ventilation in acute respiratory failure
Akashdeep Singh
CMAJ, 7 Nov 2007 [Full text]
Noninvasive ventilation and aerosol transmissible infections
Vincenzo Puro
CMAJ, 29 Nov 2007 [Full text]
Re: Another Look at Noninvasive Positive-Pressure Ventilation in acute respiratory failure
John Joseph
CMAJ, 31 Dec 2007 [Full text]