[Noninvasive ventilation: general characteristics, indications, and review of the literature]

G Ital Cardiol (Rome). 2017 Jun;18(6):496-504. doi: 10.1714/2700.27610.
[Article in Italian]

Abstract

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.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Barotrauma / etiology
  • Barotrauma / prevention & control
  • Clinical Trials as Topic
  • Continuous Positive Airway Pressure / methods
  • Continuous Positive Airway Pressure / statistics & numerical data
  • Heart Failure / therapy
  • Humans
  • Meta-Analysis as Topic
  • Myocardial Infarction / etiology
  • Myocardial Infarction / prevention & control
  • Noninvasive Ventilation* / adverse effects
  • Noninvasive Ventilation* / methods
  • Noninvasive Ventilation* / statistics & numerical data
  • Practice Guidelines as Topic
  • Pulmonary Edema / etiology
  • Pulmonary Edema / therapy
  • Respiratory Insufficiency / therapy
  • Risk