Noninvasive ventilation and high-flow nasal oxygen for acute respiratory failure: is less more?
Autor: | Rémi Coudroy, Arnaud W. Thille, Jean-Pierre Frat |
---|---|
Rok vydání: | 2020 |
Předmět: |
Exacerbation
medicine.medical_treatment Airway Extubation Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Humans Medicine Intubation Respiratory Distress Syndrome Noninvasive Ventilation Lung business.industry Oxygen Inhalation Therapy 030208 emergency & critical care medicine Oxygenation medicine.disease Oxygen Respiratory acidosis medicine.anatomical_structure 030228 respiratory system Respiratory failure Anesthesia Breathing Respiratory Insufficiency business |
Zdroj: | Current Opinion in Critical Care. 27:60-65 |
ISSN: | 1531-7072 1070-5295 |
Popis: | Purpose of review High-flow nasal oxygen and noninvasive ventilation (NIV) are two strategies representing an alternative to standard oxygen in the management of respiratory failure. Recent findings Although high-flow nasal oxygen has shown promising results in patients with de-novo acute respiratory failure, further large clinical trials are needed to determine the best oxygenation strategy. As NIV may have deleterious effects, especially in patients generating strong inspiratory efforts, protective NIV using higher levels of positive-end expiratory pressure, more prolonged sessions and additional interfaces such as helmets should be assessed in the future. Whereas NIV is the first-line ventilation strategy in patients with acute exacerbation of chronic lung diseases, high-flow nasal oxygen could be an alternative to NIV after partial reversal of respiratory acidosis. To prevent severe hypoxemia during intubation of hypoxemic patients or to prevent postextubation respiratory failure in patients at high-risk of reintubation, NIV is the best strategy for preoxygenation or immediately after extubation in ICUs. Summary New large-scale clinical trials are needed to compare high-flow nasal oxygen with standard oxygen in patients with de-novo acute respiratory failure to determine the reference treatment. After which, more protective NIV could be assessed among the more severe patients. |
Databáze: | OpenAIRE |
Externí odkaz: |