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Recommendations for Noninvasive Ventilation on Survival and Quality of Life

  • Maria Vargas
  • Carlo Bussemi
  • Carmine Iacovazzo
Chapter

Abstract

Noninvasive ventilation (NIV) is increasingly used as a first-line therapy for acute respiratory failure (ARF). Elderly age is associated with worse outcomes on mechanical ventilation in the ICU. NIV can be important for elderly patients with acute on chronic respiratory failure, acute heart failure, and de novo ARF, but also in DNI context, palliative care, and for the prevention of post-extubation ARF. Interface choice is determinant for NIV success.

There is still no agreement about the best treatment for elderly patients admitted to the ICU with acute respiratory failure. During acute heart failure, the application of a ventilatory support improves cardiac and respiratory functions: CPAP and bilevel positive airway pressure significantly reduced endotracheal intubation rates and mortality. NIV could have beneficial effects in immunocompromised elderly patients with de novo ARF. Early application of NIV, immediately after extubation, is effective in preventing post-extubation respiratory failure in a high-risk population. NIV has emerged as an additional tool in the management of impending respiratory failure and dyspnea near the end of life.

Age is an important issue to be considered, but it is not an absolute barrier to NIV. Reducing the damage associated with using the NIV and improve functional outcomes of elderly patients are the major goals.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Maria Vargas
    • 1
  • Carlo Bussemi
    • 1
  • Carmine Iacovazzo
    • 1
  1. 1.Department of Neurosciences, Reproductive and Odontostomatological SciencesUniversity of Naples “Federico II”NaplesItaly

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