Methodology of Non-invasive Mechanical Ventilation in Acute Respiratory Failure

  • G. U. Meduri

Abstract

The term acute respiratory failure refers to a severe deterioration in gas exchange that may require mechanical ventilation for life support. Instituted when conservative treatment fails, mechanical ventilation aims to correct the pathophysiology of acute respiratory failure and gas exchange abnormalities, reduce the work of breathing (WOB), and ameliorate dyspnea, while concomitant pharmacologic intervention is directed at correcting the condition that resulted in acute respiratory failure. The delivery of positive pressure ventilation (PPV) from the ventilator to the patient’s lungs requires the presence of an interface. Traditionally, an endotracheal (ET) tube is inserted into the trachea to deliver PPV. Endotracheal intubation is an invasive procedure associated with potential complications and discomfort and has confined the use of mechanical ventilation to the most severe forms of acute respiratory failure.

Keywords

Chronic Obstructive Pulmonary Disease Continuous Positive Airway Pressure Chronic Obstructive Pulmonary Disease Patient Acute Respiratory Failure Respir Crit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Meduri GU, Conoscenti CC, Menashe P, Nair S (1989) Noninvasive face mask ventilation in patients with acute respiratory failure. Chest 95: 865–870PubMedCrossRefGoogle Scholar
  2. 2.
    Meduri GU, Abou-Shala N, Fox RC, Jones CB, Leeper KV, Wunderink RG (1991) Noninvasive face mask mechanical ventilation in patients with acute hypercapnic respiratory failure. Chest 100: 445–454PubMedCrossRefGoogle Scholar
  3. 3.
    Gregoretti C, Burbi L, Berardino M, et al (1992) Non invasive mask ventilation ( NIMV) in trauma and major burn patients. Am Rev Respir Dis 145: A75CrossRefGoogle Scholar
  4. 4.
    Antonelli M, Conti G, Rocco M, et al (1998) A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 339: 429–435PubMedCrossRefGoogle Scholar
  5. 5.
    Bott J, Carroll MP, Conway JH, et al (1993) Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet 341: 1555–1557PubMedCrossRefGoogle Scholar
  6. 6.
    Ahmed AH, Fenwick L, Angus RM, Peacock AJ (1992) Nasal ventilation vs doxapram in the treatment of type II respiratory failure complicating chronic airflow obstruction. Thorax 1: 858Google Scholar
  7. 7.
    Daskalopoulou E, Tsara V, Fekete K, Koutsantas V, Christaki P (1993) Treatment of acute respiratory failure in COPD patients with positive airway pressure via nasal mask ( NPPV ). Chest 103: 271SGoogle Scholar
  8. 8.
    Brochard L, Mancebo J, Wysocki M, et al (1995) Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 333: 817–822PubMedCrossRefGoogle Scholar
  9. 9.
    Martin TJ, Sanders MH, Bierman MI, Hovis JD (1994) Non-invasive application of bi-level positive airway pressure to prevent endotracheal intubation in acute respiratory failure. Grit Care Med 23:Al29Google Scholar
  10. 10.
    Kramer N, Meyer TJ, Meharg J, Cece RD, Hill NS (1995) Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 151: 1799–1806PubMedCrossRefGoogle Scholar
  11. 11.
    Martin TJ, Hovis JD, Costantino JP, et al (2000) A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med 161: 807–813PubMedCrossRefGoogle Scholar
  12. 12.
    Bardi G, Pierotello R, Desideri M, Valdisserri L, Bottai M, Palla A (2000) Nasal ventilation in COPD exacerbations: early and late results of a prospective, controlled study. Eur Respir J 15: 98–104PubMedCrossRefGoogle Scholar
  13. 13.
    Rasanen J, Heikkila J, Downs J, Nikki P, Vaisanen I, Viitanen A (1985) Continuous positive airway pressure by face mask in acute cardiogenic pulmonary edema. Am J Cardiol 55: 296–300PubMedCrossRefGoogle Scholar
  14. 14.
    Bersten AD, Holt AW, Vedig AE, Skowronski GA, Baggoley CJ (1991) Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure delivered by face mask. N Engl J Med 325: 1825–1830PubMedCrossRefGoogle Scholar
  15. 15.
    Lin M, Yang YF, Chiang HT, Chang MS, Chiang BN, Cheitlin MD (1995) Reappraisal of continuous positive airway pressure therapy in acute cardiogenic pulmonary edema. Short-term results and long-term follow-up. Chest 107: 1379–1386Google Scholar
  16. 16.
    Takeda S, Takano T, Ogawa R (1997) The effect of nasal continuous positive airway pressure on plasma endothelin-1 concentrations in patients with severe cardiogenic pulmonary edema. Anesth Analg 84: 1091–1096PubMedGoogle Scholar
  17. 17.
    Pang D, Keenan SP, Cook DJ, Sibbald WJ (1998) The effect of positive pressure airway support on mortality and the need for intubation in cardiogenic pulmonary edema: a systematic review. Chest 114: 1185–1192PubMedCrossRefGoogle Scholar
  18. 18.
    Confalonieri M, Potena A, Carbone G, Porta RD, Tolley EA, Meduri GU (1999) Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 160: 15851591Google Scholar
  19. 19.
    Antonelli M, Conti G, Bufi M, et al (2000) Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. JAMA 283: 235–241PubMedCrossRefGoogle Scholar
  20. 20.
    Appendini L, Patessio A, Zanaboni S, et al (1994) Physiologic effects of positive end-expiratory pressure and mask pressure support during exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 149: 1069–1076PubMedCrossRefGoogle Scholar
  21. 21.
    de Lucas P, Tarancon C, Puente L, Rodriguez C, Tatay E, Monturiol JM (1993) Nasal continuous positive airway pressure in patients with COPD in acute respiratory failure. A study of the immediate effects. Chest 104: 1694–1697Google Scholar
  22. 22.
    Carrey Z, Gottfried SB, Levy RD (1990) Ventilatory muscle support in respiratory failure with nasal positive pressure ventilation. Chest 97: 150–158PubMedCrossRefGoogle Scholar
  23. 23.
    Brochard L, Isabey D, Piquet J, et al (1990) Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med 323: 15231530Google Scholar
  24. 24.
    Ambrosino N, Nava S, Bertone P, Fracchia C, Rampulla C (1992) Physiologic evaluation of pressure support ventilation by nasal mask in patients with stable COPD. Chest 101: 385–391PubMedCrossRefGoogle Scholar
  25. 25.
    Elliott MW, Aquilina R, Green M, Moxham J, Simonds AK (1994) A comparison of different modes of noninvasive ventilatory support: effects on ventilation and inspiratory muscle effort. Anaesthesia 49: 279–283PubMedCrossRefGoogle Scholar
  26. 26.
    Mehta S, Hill NS (1996) Noninvasive ventilation in acute respiratory failure. Respir Care Clin North Am 2: 267–292Google Scholar
  27. 27.
    Meduri GU (1996) Noninvasive positive-pressure ventilation in patients with acute respiratory failure. Clin Chest Med 17: 513–553PubMedCrossRefGoogle Scholar
  28. 28.
    Barach AL, Martin J, Eckman L (1937) Positive pressure respiration and its application to the treatment of acute pulmonary edema and respiratory obstruction. Proc Am Soc Clin Invest 16: 664–680Google Scholar
  29. 29.
    Meyer TJ, Hill NS (1994) Noninvasive positive pressure ventilation to treat respiratory failure. Ann Intern Med 120: 760–770PubMedCrossRefGoogle Scholar
  30. 30.
    American Thoracic Society (2001) International Consensus Conferences in Intensive Care Medicine: Noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 163: 283–291CrossRefGoogle Scholar
  31. 31.
    Tsuboi T, Ohi M, Kita H, et al (1999) The efficacy of a custom-fabricated nasal mask on gas exchange during nasal intermittent positive pressure ventilation. Eur Respir J 13: 152–156PubMedCrossRefGoogle Scholar
  32. 32.
    Soo Hoo GW, Santiago S, Williams AJ (1994) Nasal mechanical ventilation for hypercapnic respiratory failure in chronic obstructive pulmonary disease: determinants of success and failure. Crit Care Med 22: 1253–1261PubMedCrossRefGoogle Scholar
  33. 33.
    Chiang AA, Lee KC (1993) Use of nasal mask BiPAP in patients with respiratory distress after extubation. Chest 104: 135SGoogle Scholar
  34. 34.
    Ohi M, Chin K, Tsuboi T, Fukui M, Kuno K (1994) Effect of nasal resistance on the increase in ventilation during noninvasive ventilation. Am J Respir Crit Care Med 149: A643CrossRefGoogle Scholar
  35. 35.
    Vitacca M, Rubini F, Foglio K, Scalvini S, Nava S, Ambrosino N (1993) Non-invasive modalities of positive pressure ventilation improve the outcome of acute exacerbations in COPD patients. Intensive Care Med 19: 450–455PubMedCrossRefGoogle Scholar
  36. 36.
    Navalesi P, Fanfulla F, Frigerio P, Gregoretti C, Nava S (2000) Physiologic evaluation of noninvasive mechanical ventilation delivered with three types of mask in patients with chronic hypercapnic respiratory failure. Crit Care Med 28: 1785–1790PubMedCrossRefGoogle Scholar
  37. 37.
    Elliott MW, Steven MH, Phillips GD, Branthwaite MA (1990) Non-invasive mechanical ventilation for acute respiratory failure. Br Med J 300: 358–360CrossRefGoogle Scholar
  38. 38.
    Pennock BE, Kaplan PD, Carlin BW, Sabangan JS, Magovern JA (1991) Pressure support ventilation with a simplified ventilatory support system administered with a nasal mask in patients with respiratory failure. Chest 100: 1371–1376PubMedCrossRefGoogle Scholar
  39. 39.
    Benhamou D, Girault C, Faure C, Portier F, Muir JF (1992) Nasal mask ventilation in acute respiratory failure. Experience in elderly patients. Chest 102: 912–917Google Scholar
  40. 40.
    Meduri GU, Mauldin GL, Wunderink RG, et al (1994) Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia. Chest 106: 221–235PubMedCrossRefGoogle Scholar
  41. 41.
    Wysocki M, Tric L, Wolff MA, Gertner J, Millet H, Herman B (1993) Noninvasive pressure support ventilation in patients with acute respiratory failure. Chest 103: 907–913PubMedCrossRefGoogle Scholar
  42. 42.
    Jousela I (1993) Endotracheal tube versus face mask with and without continuous positive airway pressure (CPAP). Acta Anaesthesiol Scand 37: 381–385PubMedCrossRefGoogle Scholar
  43. 43.
    Criner GJ, Travaline JM, Brennan KJ, Kreimer DT (1994) Efficacy of a new full face mask for noninvasive positive pressure ventilation. Chest 106: 1109–1115PubMedCrossRefGoogle Scholar
  44. 44.
    Branson RD, Hurst JM, DeHaven CB Jr (1985) Mask CPAP: state of the art. Respir Care 30: 846–857PubMedGoogle Scholar
  45. 45.
    Linton DM, Potgieter PD (1982) Conservative management of blunt chest trauma. S Afr Med J 61 (24): 917–919PubMedGoogle Scholar
  46. 46.
    Dodds WJ, Hogan WJ, Lydon SB, Stewart ET, Stef JJ, Arndorfer RC (1975) Quantitation of pharyngeal motor function in normal human subjects. J Appl Physiol 39: 692–696PubMedGoogle Scholar
  47. 47.
    Covelli HD, Weled BJ, Beekman JF (1982) Efficacy of continuous positive airway pressure administered by face mask. Chest 81: 147–150PubMedCrossRefGoogle Scholar
  48. 48.
    Pennock BE, Crawshaw L, Kaplan PD (1994) Noninvasive nasal mask ventilation for acute respiratory failure. Institution of a new therapeutic technology for routine use. Chest 105: 441–444Google Scholar
  49. 49.
    DeVita MA, Friedman Y, Petrella V (1993) Mask continuous positive airway pressure in AIDS. Crit Care Clin 9: 137–151PubMedGoogle Scholar
  50. 50.
    Gregg RW, Friedman BC, Williams JF, McGrath BJ, Zimmerman JE (1990) Continuous positive airway pressure by face mask in Pneumocystis carinii pneumonia. Crit Care Med 18: 21–24PubMedCrossRefGoogle Scholar
  51. 51.
    Girault C, Bonmarchand G, Richard JC, et al (1995) Physiologic assessment of ventilatory mode during non invasive ventilation in acute hypercapnic respiratory failure (AHRF): assist-control (ACV). Am J Respir Crit Care Med 151: A426 (Abst)Google Scholar
  52. 52.
    Richard JC, Molano C, Tengang B, Benhamou D, Cuvellier A, Muir JF (1996) Nasal intermittent positive pressure ventilation vs bilevel pressure ventilation during acute respiratory failure in patients with COPD. Am J Respir Crit Care Med 153: A609 (Abst)Google Scholar
  53. 53.
    Nava S, Bruschi C, Ambrosino N, Paturno V, Confalonieri M (1995) Inspiratory effort during non-invasive mechanical ventilation with flow and pressure triggers in COPD patients. Intensive Care Med 21: S120 (Abst)Google Scholar
  54. 54.
    Chevrolet JC, Jolliet P, Abajo B, Toussi A, Louis M (1991) Nasal positive pressure ventilation in patients with acute respiratory failure. Difficult and time-consuming procedure for nurses. Chest 100: 775–782Google Scholar
  55. 55.
    Fernandez R, Blanch L, Valles J, Baigorri F, Artigas A (1993) Pressure support ventilation via face mask in acute respiratory failure in hypercapnic COPD patients. Intensive Care Med 19: 456–461PubMedCrossRefGoogle Scholar
  56. 56.
    Bunburaphong T, Imanaka H, Nishimura M, Hess D, Kacmarek RM (1997) Performance characteristics of bilevel pressure ventilators: a lung model study. Chest 111: 1050–1060PubMedCrossRefGoogle Scholar
  57. 57.
    Jounieaux V, Aubert G, Dury M, Delguste P, Rodenstein DO (1995) Effects of nasal positive-pressure hyperventilation on the glottis in normal awake subjects. J Appl Physiol 79: 176–185PubMedGoogle Scholar
  58. 58.
    Parreira VF, Jounieaux V, Aubert G, Dury M, Delguste PE, Rodenstein DO (1996) Nasal two-level positive-pressure ventilation in normal subjects. Effects of the glottis and ventilation. Am J Respir Crit Care Med 153: 1616–1623Google Scholar
  59. 59.
    Parreira YV, Jounieaux V, Delguste P, Dury M, Aubert G (1996) Effects of systematic changes in delivered tidal volume, inspiratory flow and respirator frequency on effective ventilation ( VI) during intermittent positive pressure ventilation applied through a nasal mask (nIPPV), in healthy subjects awake and asleep. Am J Respir Grit Care Med 153: A762Google Scholar
  60. 60.
    Jubran A, Van de Graaff WB, Tobin Mj (1995) Variability of patient-ventilator interaction with pressure support ventilation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 152: 129–136PubMedCrossRefGoogle Scholar
  61. 61.
    Shivaram U, Donath J, Khan FA, Juliano J (1987) Effects of continuous positive airway pressure in acute asthma. Respiration 52: 157–162PubMedCrossRefGoogle Scholar
  62. 62.
    Marantz S, Webster K, Patrick W, Roberts D, Oppenheimer L, Younes M (1992) Respiratory responses to different levels of proportional assist ( PAV) in ventilator dependent patients. Am Rev Respir Dis 145: A525Google Scholar
  63. 63.
    Rocker GM, Mackenzie MG, Williams B, Logan PM (1999) Noninvasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS. Chest 115: 173–177PubMedCrossRefGoogle Scholar
  64. 64.
    Ferguson GT, Gilmartin M (1995) CO2 rebreathing during BiPAP ventilatory assistance. Am J Respir Crit Care Med 151: 1126–1135PubMedGoogle Scholar
  65. 65.
    Porta R, Vitacca M, Clini E, Ambrosino N (1999) Physiological effects of posture on mask ventilation in awake stable chronic hypercapnic COPD patients. Eur Respir J 14: 517–522PubMedCrossRefGoogle Scholar
  66. 66.
    Druz WS, Sharp JT (1981) Activity of respiratory muscles in upright and recumbent humans. J Appl Physiol 51: 1552–1561PubMedGoogle Scholar
  67. 67.
    Leger P, Jennequin J, Gaussorgues P, Robert D (1988) Acute respiratory failure in COPD patient treated with noninvasive intermittent mechanical ventilation (control mode) with nasal mask. Am Rev Respir Dis 137: A63Google Scholar
  68. 68.
    Marino W (1991) Intermittent volume cycled mechanical ventilation via nasal mask in patients with respiratory failure due to COPD. Chest 99: 681–684PubMedCrossRefGoogle Scholar
  69. 69.
    Ninane V, Rypens F, Yernault JC, De Troyer A (1992) Abdominal muscle use during breathing in patients with chronic airflow obstruction. Am Rev Respir Dis 146: 16–21PubMedCrossRefGoogle Scholar
  70. 70.
    Nava S, Bruni M, Evangelisti I, et al (1996) Is non-invasive mechanical ventilation (NIMV) really time-consuming procedure compared to invasive mechanical ventilation (IMV)? Am J Respir Crit Care Med 153: A607Google Scholar
  71. 71.
    Richard JC, Muir JF, Girault C, Benhamou D, Merignac G (1995) Determinants of success of non-invasive positive pressure ventilation for hypercapnic respiratory failure in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 151: A236Google Scholar
  72. 72.
    Meduri GU, Turner RE, Abou-Shala N, Wunderink R, Tolley E (1996) Noninvasive positive pressure ventilation via face mask. First-line intervention in patients with acute hypercapnic and hypoxemic respiratory failure. Chest 109: 179–193Google Scholar
  73. 73.
    Soto L, Chernilo S, Gavilân J, Isamit D, Arancibia F, Vargas M (1996) Non invasive mechanical ventilation in COPD patients with acute hypercapnic respiratory failure. Am J Respir Crit Care Med 153: A610CrossRefGoogle Scholar
  74. 74.
    Ambrosino N, Foglio K, Rubini F, Clini E, Nava S, Vitacca M (1995) Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success. Thorax 50: 755–757PubMedCrossRefGoogle Scholar
  75. 75.
    Meecham Jones DJ, Paul EA, Grahame-Clarke C, Wedzicha JA (1994) Nasal ventilation in acute exacerbations of chronic obstructive pulmonary disease: effect of ventilator mode on arterial blood gas tensions. Thorax 49: 1222–1224PubMedCrossRefGoogle Scholar
  76. 76.
    Greenbaum DM, Miller JE, Eross B, Snyder JV, Grenvik A, Safar P (1976) Continuous positive airway pressure without tracheal intubation in spontaneously breathing patients. Chest 69: 615–620PubMedCrossRefGoogle Scholar
  77. 77.
    Suter PM, Kobel N (1981) Treatment of acute pulmonary failure by CPAP via face mask: when can intubation be avoided? Klin Wochenschr 59: 613–616PubMedCrossRefGoogle Scholar
  78. 78.
    Alsous F, Amoateng-Adjepong Y, Manthous CA (1999) Noninvasive ventilation: experience at a community teaching hospital. Intensive Care Med 25: 458–463PubMedCrossRefGoogle Scholar
  79. 79.
    Rusterholtz T, Kempf J, Berton C, et al (1995) Efficacy of facial mask pressure support ventilation (FMPSV) during acute cardiogenic pulmonary edema: a descriptive study. Am J Respir Crit Care Med 151: A422Google Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • G. U. Meduri

There are no affiliations available

Personalised recommendations