Kallet Richard H
San Francisco General Hospital, San Francisco, CA 94110, USA.
Respir Care. 2009 Feb;54(2):259-63.
This conference brought together experts on noninvasive ventilation (NIV) to discuss and debate the advances in evidence and technology over the past decade. A major impetus for the conference was that many institutions have not systematically integrated NIV into their clinical practice, despite mounting, high-level evidence supporting its effectiveness. NIV clearly improves outcomes for patients with chronic obstructive pulmonary disease and acute cardiogenic pulmonary edema when instituted as a first-line therapy. Although the evidence is less persuasive, initial intervention with NIV also might benefit a carefully selected subset of patients with acute lung injury, as well as those with acute respiratory failure who are immunocompromised. The papers in this and last month's special issue of the Journal provide an informative guide for clinicians attempting to implement NIV in their institutions. This paper summarizes the major findings from each presentation and the discussions that followed.
本次会议汇聚了无创通气（NIV）领域的专家，以讨论和辩论过去十年中证据和技术方面的进展。召开此次会议的一个主要推动因素是，尽管有越来越多的高水平证据支持无创通气的有效性，但许多机构并未将其系统地纳入临床实践。当作为一线治疗手段实施时，无创通气显然能改善慢性阻塞性肺疾病和急性心源性肺水肿患者的治疗效果。尽管证据的说服力稍弱，但对精心挑选的急性肺损伤患者亚组以及免疫功能低下的急性呼吸衰竭患者而言，初始采用无创通气干预也可能有益。本期以及上个月《期刊》特刊中的论文为试图在其机构中实施无创通气的临床医生提供了有益的指导。本文总结了每场报告的主要发现以及随后的讨论内容。
