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Internal and Emergency Medicine

, Volume 14, Issue 1, pp 139–142 | Cite as

Non-invasive ventilation in COPD exacerbation: how and why

  • Andrea Duca
  • Valentina Rosti
  • Anna Maria Brambilla
  • Roberto Cosentini
CE - Clinical Notes
  • 104 Downloads

Who

Patients with chronic obstructive pulmonary disease (COPD) often experience “exacerbations,” (AECOPD), defined as episodes of increasing respiratory symptoms, particularly dyspnea, cough and sputum production and increased sputum purulence. Many of these patients come to the emergency department (ED) in acute respiratory distress, needing prompt assessment and management. Non-invasive ventilation (NIV) is of paramount importance in the treatment of these patients [1, 2].

What

NIV consists of the application of a positive pressure to the human respiratory system from outside so that the air inflow to the lung is facilitated. The main characteristic of NIV, compared to invasive ventilation, is that the pressure is applied through a mask, avoiding endotracheal intubation.

The most effective type of NIV in patient with AECOPD gives flow with two different pressures: an inspiratory pressure (IPAP) and an expiratory pressure (EPAP).

Why

Patients with AECOPD experience an impaired lung...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

References

  1. 1.
    Papi A, Rabe KF, Rigau D et al (2017) Management of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J 49:1600791CrossRefGoogle Scholar
  2. 2.
    Margutti E, Greco I, Brambilla AM, Maraffi T, Cosentini R (2017) Non-invasive ventilation in acute respiratory failure: the key “W” questions. Intern Emerg Med 12:1307–1311CrossRefGoogle Scholar
  3. 3.
    Rochwerg B, Brochard L, Elliott MW et al (2017) Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 50:1602426CrossRefGoogle Scholar
  4. 4.
    Mas A (2014) Masip J Noninvasive ventilation in acute respiratory failure. Int J Chron Obstruct Pulmon Dis. 9:837–852Google Scholar
  5. 5.
    Dwarakanath A, Elliott MW (2013) Noninvasive ventilation in the management of acute hypercapnic respiratory failure. Breathe 9:338–348CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  1. 1.EAS, Emergenza di Alta Specializzazione, ASST Papa Giovanni XXIIIBergamoItaly
  2. 2.Emergency Medicine DepartmentIRCCS Fondazione Ca’ Granda, Ospedale Maggiore PoliclinicoMilanItaly

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