Document Detail

The role of noninvasive ventilation in the ventilator discontinuation process.
MedLine Citation:
PMID:  23013899     Owner:  NLM     Status:  In-Data-Review    
In recent years, there has been increasing interest in the use of noninvasive ventilation (NIV) in the post-extubation period to shorten the length of invasive ventilation, to prevent extubation failure, and to rescue a failed extubation. The purpose of this review is to summarize the evidence related to the use of NIV in these settings. NIV can be used to allow earlier extubation in selected patients who do not successfully complete a spontaneous breathing trial (SBT). Its use in this setting should be restricted to patients who are intubated during an exacerbation of COPD or patients with neuromuscular disease. This category of patients should be good candidates for NIV and should be extubated directly to NIV. In patients who successfully complete an SBT, but are at risk for extubation failure, NIV can be used to prevent extubation failure. These patients should also be good candidates for NIV and should be extubated directly to NIV. NIV should be used cautiously in patients who successfully complete an SBT, but develop respiratory failure within 48 hours post-extubation. In this setting, NIV is indicated only in patients with hypercapnic respiratory failure. Reintubation should not be delayed if NIV is not immediately successful in reversing the post-extubation respiratory failure. Evidence does not support routine use of NIV post-extubation.
Dean R Hess
Related Documents :
24971509 - Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including...
24131549 - Prognostic impact of systemic inflammatory diseases in elderly patients with congestive...
24169009 - Treatment patterns and outcomes in patients undergoing percutaneous coronary interventi...
23873139 - The role of implantable cardioverter-defibrillators in patients with continuous flow le...
23872999 - Bet 2: therapeutic hypothermia for cardiac arrest of asphyxial origin.
23920829 - Development of an early detection and monitoring system for deteriorating patients.
21049829 - Factors that influence adherence and strategies to maintain adherence to injected thera...
2069199 - Treatment impressions and termination experiences with borderline patients.
11854319 - Choreoathetosis, hypothyroidism, and pulmonary alterations due to human nkx2-1 haploins...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  57     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1619-25     Citation Subset:  IM    
Respiratory Care Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Evidence-based assessments in the ventilator discontinuation process.
Next Document:  The ventilator liberation process: update on technique, timing, and termination of tracheostomy.