Noninvasive Ventilation in COPD—Pressure Matters

Windisch et al discuss noninvasive Ventilation in chronic obstructive pulmonary disease (COPD). High-intensity noninvasive ventilation was first used more than 20 years ago in patients with COPD and chronic hypercapnia. High-intensity noninvasive ventilation aims to achieve normocapnia or to reduce...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2024-11, Vol.332 (20), p.1705-1706
Main Authors: Windisch, Wolfram, Stanzel, Sarah Bettina, Karagiannidis, Christian
Format: Article
Language:English
Subjects:
Chronic obstructive pulmonary disease
Clinical trials
Hypercapnia
Lung diseases
Mechanical ventilation
Ventilation
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Summary:Windisch et al discuss noninvasive Ventilation in chronic obstructive pulmonary disease (COPD). High-intensity noninvasive ventilation was first used more than 20 years ago in patients with COPD and chronic hypercapnia. High-intensity noninvasive ventilation aims to achieve normocapnia or to reduce elevated Paco2 levels to the maximally achievable extent. For this purpose, the driving pressure, mainly achieved by modifying the inspiratory positive airway pressure, is individually titrated by a stepwise increase until normocapnia is established or the tolerated maximum pressure is reached. This approach is in clear contrast to the classic approach of low-intensity noninvasive ventilation. Randomized crossover trials have established the physiological superiority of high-intensity vs low-intensity noninvasive ventilation in the chronic setting.
ISSN:0098-7484
1538-3598
1538-3598
DOI:10.1001/jama.2024.0811