Non-invasive ventilation in COPD exacerbation: how and why
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Patients with chronic obstructive pulmonary disease (COPD) often experience “exacerbations,” (AECOPD), defined as episodes of increasing respiratory symptoms, particularly dyspnea, cough and sputum production and increased sputum purulence. Many of these patients come to the emergency department (ED) in acute respiratory distress, needing prompt assessment and management. Non-invasive ventilation (NIV) is of paramount importance in the treatment of these patients [1, 2].
NIV consists of the application of a positive pressure to the human respiratory system from outside so that the air inflow to the lung is facilitated. The main characteristic of NIV, compared to invasive ventilation, is that the pressure is applied through a mask, avoiding endotracheal intubation.
The most effective type of NIV in patient with AECOPD gives flow with two different pressures: an inspiratory pressure (IPAP) and an expiratory pressure (EPAP).
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