Ventilación mecánica no invasiva en la enfermedad pulmonar obstructiva crónica y en el edema agudo de pulmón cardiogénico / Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema

La ventilación no invasiva (VNI) junto con el tratamiento convencional mejora la evolución de los pacientes con insuficiencia respiratoria aguda por descompensación hipercápnica de la enfermedad pulmonar obstructiva crónica (EPOC) o por edema agudo de pulmón cardiogénico (EAPC). Esta revisión resume los principales efectos de la VNI en dichas enfermedades. En la EPOC la VNI mejora el intercambio de gases y la clínica, reduce la necesidad de intubación endotraqueal, la mortalidad hospitalaria y la estancia hospitalaria en comparación con la oxigenoterapia convencional. Además, puede evitar la reintubación y disminuir el tiempo de ventilación mecánica invasiva. En el EAPC el tratamiento con VNI acelera la remisión de los síntomas y la normalización gasométrica, reduce la necesidad de intubación endotraqueal y se asocia a una tendencia a menor mortalidad sin aumentar la incidencia de infarto de miocardio. La modalidad ventilatoria utilizada en el EAPC no afecta el pronóstico de los pacientes

Noninvasive ventilation (NIV) with conventional therapy improves the outcome of patients with acute respiratory failure due to hypercapnic decompensation of chronic obstructive pulmonary disease (COPD) or acute cardiogenic pulmonary edema (ACPE). This review summarizes the main effects of NIV in these pathologies. In COPD, NIV improves gas exchange and symptoms, reducing the need for endotracheal intubation, hospital mortality and hospital stay compared with conventional oxygen therapy. NIV may also avoid reintubation and may decrease the length of invasive mechanical ventilation. In ACPE, NIV accelerates the remission of symptoms and the normalization of blood gas parameters, reduces the need for endotracheal intubation, and is associated with a trend towards lesser mortality, without increasing the incidence of myocardial infarction. The ventilation modality used in ACPE does not affect the patient prognosis

Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

Noninvasive ventilation (NIV) with conventional therapy improves the outcome of patients with acute respiratory failure due to hypercapnic decompensation of chronic obstructive pulmonary disease (COPD) or acute cardiogenic pulmonary edema (ACPE). This review summarizes the main effects of NIV in these pathologies. In COPD, NIV improves gas exchange and symptoms, reducing the need for endotracheal intubation, hospital mortality and hospital stay compared with conventional oxygen therapy. NIV may also avoid reintubation and may decrease the length of invasive mechanical ventilation. In ACPE, NIV accelerates the remission of symptoms and the normalization of blood gas parameters, reduces the need for endotracheal intubation, and is associated with a trend towards lesser mortality, without increasing the incidence of myocardial infarction. The ventilation modality used in ACPE does not affect the patient prognosis.