Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights.

Abstract

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.

• Authors: Gil Gonçalves, Haitham Saeed, Mohamed E Abdelrahim, Hadeer S Harb, Yasmin M Madney, Kevin Eng, Habid M R Karim, Mohamad El-Khatib, Bushra Mina, Szymon Skoczyński, Irena Sarc, Vânia Caldeira, Sara M Cabral, Bruno Cabrita, Miguel Guia, Jun Duan, Igor Barjaktarevic, Giuseppe Fiorentino, Edoardo Piervincenzi, Güniz Köksal, Sibel O Sarin, Peter J Papadakos, Benan Bayrakci, Vijay Hadda, G Laier-Groeneveld, Karen E A Burns, Raffaele Scala, Andres C Alcaraz, Antonio M Esquinas
• Journal: Advances in respiratory medicine (Adv Respir Med) Vol. 88 Issue 3 Pg. 233-244 ( 2020) ISSN: 2543-6031 [Electronic] Switzerland
• PMID: 32706107 (Publication Type: Journal Article, Review)

Topics

• Brain Diseases (etiology, prevention & control)
• Consciousness Disorders (therapy)
• Humans
• Noninvasive Ventilation (adverse effects, methods)
• Oxygen Inhalation Therapy (adverse effects, methods)
• Pulmonary Disease, Chronic Obstructive (therapy)
• Respiratory Insufficiency (therapy)
• Severity of Illness Index