Abstract
A major driving force behind the increasing use of non-invasive ventilation (NIV) has been the desire to avoid the complications of invasive ventilation. Although invasive mechanical ventilation is highly effective and reliable in supporting alveolar ventilation, endotracheal intubation is associated with numerous risks of complications. These include upper-airway injuries, tracheal stenosis, tracheomalacia, sinusitis, and ventilator-associated pneumonia [1]. Torres et al. considered the correlation between several risk factors and the development of nosocomial pneumonia: the presence of chronic obstructive pulmonary disease (COPD) and invasive ventilation for more than 3 days were significantly associated with an increased risk [2]. This complication of invasive ventilation is associated with a longer stay in the intensive care unit (ICU), increased costs and a worse outcome [2]. Furthermore, weaning difficulties are frequent in COPD patients [3], and the management of difficult-to-wean patients is a major clinical challenge that constitutes a large portion of the workload in an ICU [4].
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Hilbert, G., Vargas, F., Gruson, D. (2008). Non-invasive Ventilation in Patients with Acute Respiratory Failure and COPD or ARDS. In: Lucangelo, U., Pelosi, P., Zin, W.A., Aliverti, A. (eds) Respiratory System and Artificial Ventilation. Springer, Milano. https://doi.org/10.1007/978-88-470-0765-9_17
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