Occasional review
Rationale for the use of non-invasive ventilation in chronic ventilatory failure
P M Turkington, M W Elliott
St James's
University Hospital, Beckett Street, Leeds LS9 7TF, UK
Correspondence to: Dr M W Elliott e-mail mark.elliott@lineone.net
| The first 150 words of the full text of this article appear below. |
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Introduction |
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In recent years there has been a rapid growth of interest in the use of non-invasive ventilation (NIV) in the management of patients with acute and chronic ventilatory failure. This paper reviews the evidence for the effectiveness of NIV in the management of chronic hypercapnic ventilatory failure and discusses possible mechanisms by which NIV has an effect.
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Evidence base for the use of NIV in chronic ventilatory failure |
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SLOWLY PROGRESSIVE NEUROMUSCULAR DISEASE AND CHEST WALL
DISORDERS
Several uncontrolled studies have shown benefit from nocturnal NIV
in terms of improvement in daytime arterial blood gas tensions, relief
of the symptoms of nocturnal hypoventilation, and improved survival
compared with that which would be expected without treatment in
patients with neuromuscular and chest wall diseases.1-5
In a large case series Leger et
al6 reported on 276 patients with chronic
ventilatory failure. In patients with kyphoscoliosis or sequelae of
previous tuberculosis (usually thoracoplasty) they found a significant
improvement in diurnal arterial oxygen and carbon dioxide tensions
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