Acute Chronic Insufficiency

  • María Sevilla Martínez
  • Lorena Olivencia Peña
  • Alberto Fernández Carmona


The profile of the patient is changing, they are older and with more comorbidity, probably not candidates for invasive measures. This explains that use of NIV has spread in recent years in elderly patients with respiratory failure.

Use of NIV reduces the need for Endotracheal Intubation (ETI), improves survival, and induces a faster resolution of respiratory distress compared to standard medical therapy although it depends on the etiology of respiratory failure.



Acute cardiogenic pulmonary edema


Acute respiratory insufficiency


Congestive heart failure


Chronic obstructive pulmonary disease


Do not intubate


Endotracheal intubation


Intensive care unit


Non-invasive ventilation


Positive pressure at the end of the expiration


  1. 1.
    Segrelles-Calvo G, Zamora-Garcia E, Giron-Moreno R, et al. Non-invasive ventilation in an elderly population admitted to a respiratory monitoring unit: causes, complications and one-year evolution. Arch Bronconeumol. 2012;48(10):349–54.CrossRefGoogle Scholar
  2. 2.
    Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374(9685):250–9.CrossRefGoogle Scholar
  3. 3.
    Ferrer M. Ventilación mecánica no invasiva y pronostico de la enfermedad pulmonar obstructiva crónica. Arch Bronconeumol. 2010;46(8):399–401.CrossRefGoogle Scholar
  4. 4.
    Nava S, Grassi M, Fanfulla F, et al. Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomized controlled trial. Age Ageing. 2011;40(4):444–50.CrossRefGoogle Scholar
  5. 5.
    Diaz-Lobato S, Mayorales-Alises S, Montiel G. Ventilación mecánica no invasiva en al agudizacion de las enfermedades respiratorias. Med Clin. 2011;137(15):691–6.CrossRefGoogle Scholar
  6. 6.
    Curtis JR, Cook DJ, Sinuff T, et al. Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med. 2007;35:932–9.CrossRefGoogle Scholar
  7. 7.
    Schettino G, Altobelli N, Kacmarek R. Noninvasive positive pressure ventilation reverses acute respiratory failure in select “do-not-intubate” patients. Crit Care Med. 2005;33(9):1976–82.CrossRefGoogle Scholar
  8. 8.
    Kacmarek R. Should noninvasive ventilation be used with the do-not-intubate patient? Respir Care. 2009;54(2):223–9.Google Scholar
  9. 9.
    Esteban A, Frutos-Vivar F, Ferguson ND, et al. Noninvasive positive pressure ventilation for respiratory failure after extubation. N Engl J Med. 2004;350(24):2452–60.CrossRefGoogle Scholar
  10. 10.
    Johnson T, Richman P, Allegra J, et al. Intubations in elderly patients have decreased from 1999 through 2014—results of a multi-center cohort study. Am J Emerg Med. 2018;36(11):1964–6.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • María Sevilla Martínez
    • 1
  • Lorena Olivencia Peña
    • 1
  • Alberto Fernández Carmona
    • 1
  1. 1.Intensive Care UnitHospital Universitario Virgen de las NievesGranadaSpain

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