Non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease

摘要

Between a fifth and a third of patients admitted to hospital with hypercapnic respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease will die in hospital, despite selective use of mechanical ventilation. In severe chronic obstructive pulmonary disease, hyperinflation places the respiratory muscles at a mechanical disadvantage and they function dose to their maximum capacity." During acute exacerbations, elastic and resistive loads on the respiratory muscles increase and may lead to ventilatory failure. The ensuing tissue acidosis further impairs respiratory muscle function, producing a vicious cycle. Thus a logical approach is to assist the compromised "respiratory muscle pump".