Friolet Raymond, Liaudet Lucas, Eckert Philippe
Service des soins intensifs multidisciplinaires, Centre hospitalier du Centre du Valais, Hôpital de Sion.
Rev Med Suisse Romande. 2004 Jun;124(6):337-40.
Noninvasive ventilation (NIV) refers to the delivery of mechanical ventilation using a nasal or facial mask. Compared to mechanical ventilation with endotracheal intubation, the occurence of complications, mainly infectious, is reduced by NIV. Reduction of respiratory workload and improvement of gas exchange are achieved with the use of NIV. In patients with exacerbations of chronic obstructive pulmonary disease (COPD), NIV reduces the need for endotracheal intubation, the length of ICU stay and the mortality. It is equally effective in acute cardiogenic pulmonary edema and for ventilatory weaning of patients with COPD. In selected groups of patients with acute hypoxemic respiratory failure, NIV diminishes the rate of endotracheal intubation and improves survival. The purpose of this article is to review the mechanisms, the technical aspects and the indications of NIV for the treatment of acute respiratory failure.
无创通气(NIV)是指通过鼻罩或面罩进行机械通气。与气管插管机械通气相比,无创通气可减少主要为感染性并发症的发生。使用无创通气可减轻呼吸负荷并改善气体交换。在慢性阻塞性肺疾病(COPD)急性加重患者中,无创通气可减少气管插管需求、缩短重症监护病房(ICU)住院时间并降低死亡率。它在急性心源性肺水肿以及COPD患者的通气撤机方面同样有效。在选定的急性低氧性呼吸衰竭患者组中,无创通气可降低气管插管率并提高生存率。本文旨在综述无创通气治疗急性呼吸衰竭的机制、技术方面及适应证。