Hatipoğlu Umur, Aboussouan Loutfi Sami
Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
BMJ Med. 2022 Aug 1;1(1):e000146. doi: 10.1136/bmjmed-2022-000146. eCollection 2022.
Chronic obstructive pulmonary disease (COPD) should no longer be seen as a condition for which little can be done. Novel pharmacotherapeutic interventions, surgical and procedural advances, and respiratory assist devices have provided numerous ways to help patients with COPD and treatable traits. For nearly 30 years, non-invasive ventilation, the application of positive pressure through a mask interface placed outside of the airway, has been the cornerstone for treatment of acute hypercapnic respiratory failure due to COPD exacerbation. Clinical trials indicate that this intervention could benefit patients with COPD and chronic hypercapnic respiratory failure in a stable state. This narrative review aims to provide the necessary background for internists to consider this therapeutic option for their COPD patients. We discuss the mechanism of action and implementation, and provide a glimpse into the future of this promising intervention.
慢性阻塞性肺疾病（COPD）不应再被视为一种束手无策的疾病。新型药物治疗干预、手术及操作进展以及呼吸辅助设备为帮助慢性阻塞性肺疾病患者及治疗可治疗特征提供了众多方法。近30年来，无创通气，即通过置于气道外的面罩接口施加正压，一直是治疗慢性阻塞性肺疾病急性加重所致急性高碳酸血症呼吸衰竭的基石。临床试验表明，这种干预措施可能使处于稳定状态的慢性阻塞性肺疾病和慢性高碳酸血症呼吸衰竭患者受益。本叙述性综述旨在为内科医生考虑将这种治疗选择用于其慢性阻塞性肺疾病患者提供必要背景。我们讨论其作用机制和实施方法，并展望这一有前景的干预措施的未来。
