Ventilatory Support and Oxygen Therapy in the Elderly Palliative and End-of-Life Care Patients
An ageing population and steady increase in the rates of neoplasms and chronic degenerative diseases poses a challenge for societies and their healthcare systems. Because of the recent and continued advances in therapies, such as the development and widespread use of non-invasive ventilation (NIV), survival rates have increased for these pathologies. For patients with end-stage chronic respiratory diseases, the use of NIV following the onset of acute or severe chronic respiratory failure is a valid option when intubation has been excluded. The available evidence strongly supports the use of NIV in patients presenting with an exacerbation of COPD, as well end-stage neuromuscular disease. Few studies support the use of NIV in end-stage interstitial lung disease. In patients with cancer it has been recommended offering NIV as palliative care to improve dyspnoea. The decision regarding the treatment should be made by the patient, ideally before reaching the terminal stage and after having a frank dialogue with healthcare professionals and family members.
- 8.Murphy PB, Rehal S, Arbane G, Bourke S, Calverley PMA, Crook AM, Dowson L, Duffy N, Gibson GJ, Hughes PD, Hurst JR, Lewis KE, Mukherjee R, Nickol A, Oscroft N, Patout M, Pepperell J, Smith I, Stradling JR, Wedzicha JA, Polkey MI, Elliott MW, Hart N. Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation a randomized clinical trial. JAMA. 2017;317:2177–86.CrossRefGoogle Scholar