Noninvasive ventilation using a mouthpiece in patients with chronic obstructive pulmonary disease and acute respiratory failure.

Noninvasive positive pressure ventilation (NPPV) delivered via a mouthpiece (mNPPV) has been successfully used in stable chronic restrictive respiratory insufficiency, but not in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF). The purpose of this matched case-control study was to compare the usefulness of mNPPV to noninvasive ventilation using a nasal or oronasal mask (nNPPV) or standard medical treatment (SMT) in COPD patients with ARF. Twenty-nine patients receiving mNPPV were matched with 29 patients receiving nNPPV and 29 patients receiving SMT regarding age, SAPSII, admission PaCO(2) and pH. In the mNPPV group, admission PaCO(2) and pH were 78.6 +/- 12 mm Hg and 7.30 +/- 0.04, respectively. mNPPV and nNPPV avoided the need for endotracheal intubation in 27 and 25 patients, respectively (nonsignificant) whereas SMT resulted in a higher mechanical ventilation rate (13 patients). At the end of the treatment protocol, PaCO(2) was lower in the mNPPV group (62.2 +/- 9.6 mm Hg) than in the SMT group (72.4 +/- 20.4 mm Hg, p < 0.018) leading to a significantly higher pH. No significant differences were observed between the mNPPV and nNPPV groups. In case of moderate respiratory acidosis, noninvasive ventilation using a mouthpiece significantly reduces the endotracheal intubation rate in comparison with SMT and therefore appears to be a second-line alternative to noninvasive ventilation delivered via a mask, especially when poorly tolerated.

Glerant JC ，Rose D ，Oltean V ，Dayen C ，Mayeux I ，Jounieaux V ... -  《-》

[Study of the use of noninvasive ventilation of the lungs in acute respiratory insufficiency due exacerbation of chronic obstructive pulmonary disease].

Avdeev SN ，Tret'iakov AV ，Grigor'iants RA ，Kutsenko MA ，Chuchalin AG ... -  《-》

[Use of noninvasive mechanical ventilation to avoid intubation during acute respiratory insufficiency].

Brijker F ，van den Elshout FJ ，de Rijk A ，Folgering HT ，Bosch FH ... -  《-》

Pressure support noninvasive positive pressure ventilation treatment of acute cardiogenic pulmonary edema.

Wigder HN ，Hoffmann P ，Mazzolini D ，Stone A ，Scholly S ，Clark J ... -  《AMERICAN JOURNAL OF EMERGENCY MEDICINE》

Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial.

Conti G ，Antonelli M ，Navalesi P ，Rocco M ，Bufi M ，Spadetta G ，Meduri GU ... -  《-》