Respiratory Intensive and Intermediate Care Unit, Department of Pneumology, Respiratory Institute, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
Semin Respir Crit Care Med. 2020 Dec;41(6):786-797. doi: 10.1055/s-0040-1712101. Epub 2020 Jul 28.
Noninvasive ventilation (NIV) is considered to be the standard of care for the management of acute hypercapnic respiratory failure in patients with chronic obstructive pulmonary disease exacerbation. It can be delivered safely in any dedicated setting, from emergency rooms to high dependency or intensive care units and wards. NIV helps improving dyspnea and gas exchange, reduces the need for endotracheal intubation, and morbidity and mortality rates. It is therefore recognized as the gold standard in this condition. High-flow nasal therapy helps improving ventilatory efficiency and reducing the work of breathing in patients with severe chronic obstructive pulmonary disease. Early studies indicate that some patients with acute hypercapnic respiratory failure can be managed with high-flow nasal therapy, but more information is needed before specific recommendations for this therapy can be made. Therefore, high-flow nasal therapy use should be individualized in each particular situation and institution, taking into account resources, and local and personal experience with all respiratory support therapies.
无创通气（NIV）被认为是治疗慢性阻塞性肺疾病加重期急性高碳酸血症性呼吸衰竭的标准治疗方法。它可以在任何专门的环境中安全地提供，从急诊室到高依赖或重症监护病房和病房。NIV 有助于改善呼吸困难和气体交换，减少气管插管的需求，降低发病率和死亡率。因此，它被认为是这种情况下的黄金标准。高流量鼻治疗有助于提高通气效率，减少严重慢性阻塞性肺疾病患者的呼吸功。早期研究表明，一些急性高碳酸血症性呼吸衰竭患者可以通过高流量鼻治疗来治疗，但需要更多的信息，才能对这种治疗方法提出具体建议。因此，应根据每个特定情况和机构的资源，以及对所有呼吸支持治疗的当地和个人经验，个体化使用高流量鼻治疗。
