Peñuelas Oscar, Frutos-Vivar Fernando, Esteban Andrés
Intensive Care Service, Hospital Universitario de Getafe, Madrid, Spain.
CMAJ. 2007 Nov 6;177(10):1211-8. doi: 10.1503/cmaj.060147.
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.
无创正压通气是一种无需人工气道的机械通气方式。20世纪90年代发表的评估该技术治疗慢性阻塞性肺疾病、充血性心力衰竭和急性呼吸衰竭等疾病疗效的研究，近年来已推广其应用。重要问题包括通气界面的选择和呼吸机类型。目前可用的界面包括鼻罩、口鼻面罩、全面罩、口含器和头盔。现有界面的比较并未显示出哪一种明显更具优势。重症监护呼吸机和便携式呼吸机均可用于无创正压通气；然而，呼吸机类型的选择取决于患者的病情和治疗需求，以及医护人员的专业知识和护理地点。据报道，慢性阻塞性肺疾病加重期患者和心源性肺水肿患者使用无创正压通气取得了最佳效果（减少插管需求和降低死亡率）。
