Cystic Fibrosis Department, "Agia Sofia" Children's Hospital, Athens, Greece.
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Respir Care. 2021 Aug;66(8):1330-1336. doi: 10.4187/respcare.08755. Epub 2021 May 25.
In patients with cystic fibrosis (CF), despite the availability of many different pharmacologic agents, lung function deteriorates and lung disease progresses and leads to hypercapnic respiratory failure in some patients. In such cases, noninvasive ventilation (NIV) seems to be a promising technique that can be used on demand. This review summarizes the current applications of NIV in clinical settings as well as findings of the clinical trials that involved the delivery of NIV on variable occasions, such as an adjunct to physiotherapy, in nocturnal hypoventilation, and acute and chronic respiratory failure. NIV has been used in patients with CF and with advanced lung disease who are not considered candidates for lung transplantation. It can stabilize lung function, although its effect on hypercapnia is not always evident. Nocturnal NIV has been used in patients with CF and with hypoventilation during sleep but without clear benefits on daytime [Formula: see text] NIV as an adjunct to chest physiotherapy may be helpful when desaturation is observed during physiotherapy and when there are signs of respiratory muscle fatigue. NIV use in CF has been increasing, mainly in adult CF centers, and offers patients an opportunity to reach lung transplantation or to overcome acute hypercapnic respiratory failure.
在囊性纤维化(CF)患者中,尽管有许多不同的药物可供选择,但肺功能仍会恶化,肺部疾病仍会进展,并导致一些患者发生高碳酸血症性呼吸衰竭。在这种情况下,无创通气(NIV)似乎是一种有前途的技术,可以按需使用。这篇综述总结了 NIV 在临床环境中的当前应用,以及涉及在不同情况下(如作为物理治疗的辅助手段、夜间低通气、急性和慢性呼吸衰竭)提供 NIV 的临床试验结果。NIV 已用于 CF 患者和晚期肺病患者,这些患者不被认为是肺移植的候选人。它可以稳定肺功能,尽管它对高碳酸血症的影响并不总是明显。夜间 NIV 已用于 CF 患者和睡眠期间低通气的患者,但对白天的[公式:见正文]没有明显益处。NIV 作为物理治疗的辅助手段,当在物理治疗过程中观察到低氧血症和呼吸肌疲劳迹象时可能会有所帮助。CF 中 NIV 的使用正在增加,主要是在成人 CF 中心,为患者提供了进行肺移植或克服急性高碳酸血症性呼吸衰竭的机会。