The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation

Hess, Dean R

doi:10.4187/respcare.01692

Cited by 59Respiratory Support and MechanismsObstructive Sleep Apnea ResearchNeonatal Respiratory Health Research

The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation

Hess, Dean R·2012·Respiratory Care

DOI 10.4187/respcare.01692

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Abstract

For many patients with chronic respiratory failure requiring ventilator support, noninvasive ventilation (NIV) is preferable to invasive support by tracheostomy. Currently available evidence does not support the use of nocturnal NIV in unselected patients with stable COPD. Several European studies have reported benefit for high intensity NIV, in which setting of inspiratory pressure and respiratory rate are selected to achieve normocapnia. There have also been studies reporting benefit for the use of NIV as an adjunct to exercise training. NIV may be useful as an adjunct to airway clearance techniques in patients with cystic fibrosis. Accumulating evidence supports the use of NIV in patients with obesity hypoventilation syndrome. There is considerable observational evidence supporting the use of NIV in patients with chronic respiratory failure related to neuromuscular disease, and one randomized controlled trial reported that the use of NIV was life-prolonging in patients with amyotrophic lateral sclerosis. A variety of interfaces can be used to provide NIV in patients with stable chronic respiratory failure. The mouthpiece is an interface that is unique in this patient population, and has been used with success in patients with neuromuscular disease. Bi-level pressure ventilators are commonly used for NIV, although there are now a new generation of intermediate ventilators that are portable, have a long battery life, and can be used for NIV and invasive applications. Pressure support ventilation, pressure controlled ventilation, and volume controlled ventilation have been used successfully for chronic applications of NIV. New modes have recently become available, but their benefits await evidence to support their widespread use. The success of NIV in a given patient population depends on selection of an appropriate patient, selection of an appropriate interface, selection of an appropriate ventilator and ventilator settings, the skills of the clinician, the motivation of the patient, and the support of the family.

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Previous studies suggested that misuse or rejection of medication or NIV can be influenced by psychological factors such as anxiety, depression, health beliefs, and cognitive impairment.
“Previous studies suggested that the misuse or rejection of medication or NIV can be influenced by some psychological factors such as anxiety, depression, health beliefs, and cognitive impairment (27–29); the unacknowledged recognition of the illness; and the use of different devices and medications due to comorbidities (30–32).”
From Promoting Acceptance and Adherence to Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. (2022) · cites this paper as [32]
No study has identified the individual psychological factors that increase the risk of rejection or improper use of NIV.
“No study has identified the individual psychological factors that increase the risk of rejection or improper use of NIV.”
From A psychological intervention to promote acceptance and adherence to non-invasive ventilation in people with chronic obstructive pulmonary disease: study protocol of a randomised controlled trial. (2017) · cites this paper as [32]

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Authors: Hess, D. R.
Affiliations: Harvard University (US)
Corresponding author: Hess, Dean R
Venue: Respiratory Care
Publisher: SAGE Publications
Published: 2012-06-01
Volume: 57
Issue: 6
Pages: 900-920
ISSN: 0020-1324 (ISSN-L)
DOI: 10.4187/respcare.01692
OpenAlex: W2145075963
Cited by: 59
References: 191
Citations by year: 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 8 · 2013: 4 · 2012: 4
FWCI: 1.19
Type: journal article
Language: en
Open access: closed
Licence: www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations: Respiratory Care (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Keywords: non-invasive ventilation, prolonged mechanical ventilation, chronic respiratory failure, chronic obstructive pulmonary disease, cystic fibrosis, obesity hypoventilation syndrome, neuromuscular disorders, amyotrophic lateral sclerosis, normocapnia, exercise training, airway clearance, pressure support ventilation, patient selection
MeSH terms: Amyotrophic Lateral Sclerosis, Cystic Fibrosis, Equipment Design, Medicare, Humans, Neuromuscular Diseases, Obesity Hypoventilation Syndrome, Respiration, Artificial, Ventilators, Mechanical, Sleep Apnea Syndromes, Tidal Volume, Time Factors, United States, Insurance Coverage, Muscular Dystrophy, Duchenne, Pulmonary Disease, Chronic Obstructive

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The growing role of noninvasive ventilation in patients requiring prolonged mechanical ventilation

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