| Autor: |
Vagnarelli F; U.O. Cardiologia-Emodinamica-UTIC, Ospedale Mazzoni, Ascoli Piceno - Area Giovani ANMCO., Marini M; S.O.D. Cardiologia-Emodinamica-UTIC, Dipartimento di Scienze Cardiovascolari, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona - Area Giovani ANMCO., Caretta G; S.C. Cardiologia-Emodinamica-UTIC, Dipartimento di Emergenza e Accettazione, Ospedale S. Andrea, ASL 5, La Spezia - Area Giovani ANMCO., Lucà F; Cardiologia Interventistica-UTIC, A.O. 'Bianchi Melacrino Morelli', Reggio Calabria - Area Giovani ANMCO., Biscottini E; S.C. Cardiologia-Emodinamica-UTIC, Ospedale San Giovanni Battista, ASL Umbria 2, Foligno (PG) - Area Giovani ANMCO., Lavorgna A; U.O.C. Cardiologia-UTIC, Dipartimento Cardiovascolare, P.O. 'G. Mazzini', Teramo - Area Giovani ANMCO., Procaccini V; Cardiologia Interventistica-UTIC, A.O. 'G. Rummo', Benevento - Area Giovani ANMCO., Riva L; U.O.C. Cardiologia, Ospedale Maggiore, Bologna - Area Giovani ANMCO., Vianello G; U.O. Cardiologia-UTIC, Ospedale 'Madonna della Navicella', ASL 14 Chioggia (VE) - Area Giovani ANMCO., Aspromonte N; U.O.C. Cardiologia, P.O. San Filippo Neri, ASL RME, Roma - Area Scompenso Cardiaco ANMCO., Pini D; U.O. Cardiologia dello Scompenso, Humanitas Research Hospital, Rozzano (MI) - Area Scompenso Cardiaco ANMCO., Navazio A; S.O.C. Cardiologia-UTIC, Ospedale Civile Guastalla, Azienda USL di Reggio Emilia - Area Scompenso Cardiaco ANMCO., De Maria R; Istituto di Fisiologia Clinica del CNR, Dipartimento Cardiotoracovascolare, Grande Ospedale Metropolitano Niguarda, Milano - Area Giovani ANMCO., Valente S; S.O.D. Cardiologia Intensiva Integrata, AOU Careggi, Firenze - Area Emergenza-Urgenza ANMCO., Gulizia MM; Divisione di Cardiologia, Ospedale 'Garibaldi-Nesima', Catania - Past President ANMCO. |
| Abstrakt: |
Noninvasive ventilation (NIV), including both continuous and bilevel positive airway pressure, plays a pivotal role in the treatment of acute respiratory failure secondary to acute heart failure. For an appropriate use of NIV, it is essential to consider the underlying pathophysiological principles, the differences between the different modes of ventilation, the main indications, contraindications and complications. The aim of this review is also to give practical guidance on how and when to start NIV at the bedside, how to monitor the response and how to choose the most appropriate interface. A review of the literature supports the use of NIV in terms of efficacy (reduction in intubation and mortality) and safety (in particular, the risk of myocardial infarction associated with its use, suggested by a previous study, has been definitely confuted). Nevertheless, NIV is still largely underused in contemporary clinical practice, as reported by data from real-world registries. This may be due to several factors, including lack of knowledge/confidence, reluctance of application in particular settings (acute coronary syndromes) and the risk of adverse effects (hypotension), which need to be reappraised. |
