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 CosentiniEmail author
CE - Clinical Notes


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].


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).


Patients with AECOPD experience an impaired lung...


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.


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    Rochwerg B, Brochard L, Elliott MW et al (2017) Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 50:1602426CrossRefPubMedGoogle Scholar
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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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