Bhattacharyya D, Prasad Bnbm, Rajput A K
Senior Advisor (Medicine & Respiratory Med), MH CTC, Pune - 40.
Commandant, MH Wellington, Tamil Nadu.
Med J Armed Forces India. 2011 Apr;67(2):187-91. doi: 10.1016/S0377-1237(11)60034-8. Epub 2011 Jul 21.
Non-invasive positive pressure ventilation (NIPPV) is the technique of delivering mechanical ventilation without endotracheal intubation or tracheostomy. This is increasingly being utilised in both acute and chronic conditions. Strong evidence supports the use of NIPPV for acute respiratory failure (ARF) to prevent endotracheal intubation (ETI) and to facilitate extubation in patients with acute exacerbations of chronic obstructive pulmonary disease, to avoid ETI in acute cardiogenic pulmonary oedema (ACPO), and in immunocompromised patients. Weaker evidence supports the use of NIPPV for patients with ARF due to asthma exacerbations, with postoperative ARF, pneumonia and acute lung injury/acute respiratory distress syndrome. NIPPV should be applied under close monitoring for signs of treatment failure and, in such cases, ETI should be promptly available. A trained team, at an appropriate location, with careful patient selection and optimal choice of devices can optimise the outcome of NIPPV.
无创正压通气（NIPPV）是一种在不进行气管插管或气管切开的情况下提供机械通气的技术。这种技术在急性和慢性疾病中越来越多地得到应用。有力证据支持在急性呼吸衰竭（ARF）中使用NIPPV，以预防气管插管（ETI），并促进慢性阻塞性肺疾病急性加重患者的拔管，避免急性心源性肺水肿（ACPO）患者进行ETI，以及用于免疫功能低下的患者。证据较弱，支持在哮喘急性发作、术后ARF、肺炎和急性肺损伤/急性呼吸窘迫综合征导致的ARF患者中使用NIPPV。NIPPV应在密切监测治疗失败迹象的情况下应用，在这种情况下，应随时可进行ETI。一个经过培训的团队，在合适的地点，仔细选择患者并优化设备选择，可以优化NIPPV的治疗效果。
