慢性阻塞性肺疾病慢性呼吸衰竭的管理：高、低强度通气。
Management of Chronic Respiratory Failure in Chronic Obstructive Pulmonary Disease: High-Intensity and Low-Intensity Ventilation.
机构信息
Division of Pulmonary, Critical Care, and Sleep Medicine, UC San Diego School of Medicine, 9300 Campus Point Drive, MC 7381, La Jolla, CA 92130, USA.
Hospital Universitario de la Princesa, Calle Diego de León 62, Madrid 28006, Spain.
出版信息
Sleep Med Clin. 2020 Dec;15(4):497-509. doi: 10.1016/j.jsmc.2020.08.007.
A significant body of literature supports the benefit of noninvasive ventilation (NIV) for acute hypercapnia in the setting of exacerbations of chronic obstructive pulmonary disease (COPD). In those with severe COPD with chronic hypercapnic respiratory failure, however, the role of NIV has been more controversial. This article reviews the physiologic basis for considering NIV in patients with COPD, summarizes existing evidence supporting the role of NIV in COPD, highlights the patient population and ventilatory approach most likely to offer benefit, and suggests a potential clinical pathway for managing patients.
大量文献支持无创通气（NIV）在慢性阻塞性肺疾病（COPD）加重期急性高碳酸血症中的作用。然而，对于伴有慢性高碳酸血症呼吸衰竭的严重 COPD 患者，NIV 的作用一直存在争议。本文回顾了考虑 COPD 患者应用 NIV 的生理学基础，总结了支持 NIV 在 COPD 中作用的现有证据，强调了最有可能获益的患者人群和通气方法，并提出了一种管理患者的潜在临床路径。
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