How effective is noninvasive positive-pressure ventilation (NPPV) in COPD and asthma?

Updated: Apr 07, 2020
  • Author: Allon Amitai, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Reviews of the literature have shown noninvasive positive-pressure ventilation (NPPV) to be beneficial for COPD, reducing the rate of tracheal intubations and the length of stay. [2] Clinical guidelines recommend that NPPV be considered as an adjunct to standard medical therapy in patients with severe COPD exacerbations (pH < 7.35 and relative hypercarbia), as well as in patients with cardiogenic pulmonary edema and respiratory failure without shock or acute coronary syndrome requiring urgent percutaneous coronary intervention. [6]

The use of NPPV has been less well studied in asthma, though a recent meta-analysis found that NPPV improved secondary outcomes such as number of hospital admissions, length of ICU stay, and length of hospital stay, as well as had a favorable effects on certain lung function parameters such as peak expiratory flow, forced vital capacity, and FEV1. [7] However, the study did not demonstrate a definite benefit ofNPPV for mortality or intubation rates.

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