RESEARCH ARTICLE


Pathophysiological Basis of Acute Respiratory Failure on Non-Invasive Mechanical Ventilation



C Romero-Dapueto 1, H Budini 1, F Cerpa 1, D Caceres 1, V Hidalgo 1, T Gutiérrez 1, J Keymer , R Pérez 1, J Molina 2, C Giugliano-Jaramillo*, 1
1 Servicio de Medicina Física y Rehabilitación, Clínica Alemana de Santiago, Santiago, Chile
2 Escuela de Kinesiología, Universidad del Desarrollo, Santiago, Chile


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© Romero-Dapueto et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Servicio de Medicina Física y Rehabilitación, Clínica Alemana de Santiago, Avenida Vitacura 5951, Vitacura, Santiago, Chile; Tel: +56222101421; Fax: +56222101421; E-mail: cgiuglianoj@alemana.cl


Abstract

Noninvasive mechanical ventilation (NIMV) was created for patients who needed noninvasive ventilator support, this procedure decreases the complications associated with the use of endotracheal intubation (ETT). The application of NIMV has acquired major relevance in the last few years in the management of acute respiratory failure (ARF), in patients with hypoxemic and hypercapnic failure. The main advantage of NIMV as compared to invasive mechanical ventilation (IMV) is that it can be used earlier outside intensive care units (ICUs). The evidence strongly supports its use in patients with COPD exacerbation, support in weaning process in chronic obstructive pulmonary disease (COPD) patients, patients with acute cardiogenic pulmonary edema (ACPE), and Immunosuppressed patients. On the other hand, there is poor evidence that supports the use of NIMV in other pathologies such as pneumonia, acute respiratory distress syndrome (ARDS), and during procedures as bronchoscopy, where its use is still controversial because the results of these studies are inconclusive against the decrease in the rate of intubation or mortality.

Keywords: Acute pulmonary edema, acute respiratory failure, COPD, immunosuppress patients, non-invasive ventilation.