Noninvasive ventilation: has Pandora’s box been opened?

Abstract

Ari Manuel1, Richard EK Russell2, Quentin Jones31Department of Respiratory Medicine, High Wycombe Hospital, Bucks, UK; 2Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK; 3Specialist Registrar, Department of Respiratory Medicine, Churchill Hospital, OxfordExacerbations of COPD are the largest single cause of hospital admission with respiratory disease, and are frequently associated with impaired gas exchange and mortality rates of up to 14%. Acute hypercapnic respiratory failure leads to admissions to intensive care units with a mortality rate of 59% at one year. Noninvasive ventilation (NIV) is a well established and validated therapy for acidotic hypercapnia respiratory failure in COPD, a leading cause of global mortality and morbidity. The use of NIV in patients with acute type II or chronic respiratory failure has increased over the past 10 years.