Division of Pulmonary and Sleep Medicine, Salem Veterans Affairs Medical Center, 1970 Roanoke Boulevard, Salem, VA 24153, USA; Department of Medicine, University of Virginia, Charlottesville, VA 22913, USA.
Division of Pulmonary and Critical Care Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Arkes Pavilion, Suite 1400, Chicago, IL 60611, USA.
Med Clin North Am. 2022 Nov;106(6):961-969. doi: 10.1016/j.mcna.2022.07.004. Epub 2022 Oct 3.
Despite the heterogeneity of data on the role of noninvasive ventilation (NIV) in severe stable chronic obstructive pulmonary disease with chronic hypercapnia, the current evidence supports the use of NIV in select populations and phenotypes. The Center for Medicare and Medicaid Services reimbursement criteria are complex, and the practice of navigating the most efficient method to initiate NIV therapy continues to be challenging. These patients optimally require referral to a medical center that has physicians with specific training in pulmonary and sleep medicine, who can navigate the specific needs for the use of NIV.
尽管在无创通气（NIV）在伴有慢性高碳酸血症的严重稳定慢性阻塞性肺疾病中的作用方面的数据存在异质性，但目前的证据支持在特定人群和表型中使用 NIV。医疗保险和医疗补助服务中心（Centers for Medicare and Medicaid Services，CMS）的报销标准较为复杂，而且要找到启动 NIV 治疗的最有效方法，这一实践仍具有挑战性。这些患者最需要转至有专门接受过肺病学和睡眠医学培训的医生的医疗中心，这些医生能够满足使用 NIV 的具体需求。
