6533b829fe1ef96bd128adf8
RESEARCH PRODUCT
Sedation and analgesia during noninvasive ventilation (NIV)
Cesare GregorettiMarinella PugliesiLara PisaniJacopo TramarinGiuliano Lo Biancosubject
COPDbusiness.industrySedationmedicine.medical_treatmentMortality rateventilationTracheal intubation030208 emergency & critical care medicineEndotracheal intubationmedicine.disease03 medical and health sciences0302 clinical medicine030228 respiratory systemsedationAnesthesiamedicineDeliriumNoninvasive ventilationmedicine.symptomDexmedetomidinebusinessmedicine.drugdescription
The use of noninvasive ventilation (NIV) has increased significantly in patients with acute respiratory failure (ARF) in order to prevent tracheal intubation and its complications. Unfortunately, NIV failure represents a frequent event, with rates that in some cases reach 40%. Mask intolerance, agitation, and delirium may lead to NIV failure, thus requiring endotracheal intubation. NIV failure rates are higher in patients without chronic obstructive pulmonary disease (COPD), and, when used in acute hypoxemic failure, its failure is associated with an increased mortality rate. The practice of sedation during NIV could be a valuable option for patients at risk of intubation. Sedation may decrease patient's discomfort and agitation which is often related to mask intolerance, without significant effects on respiratory drive, respiratory frequency, or hemodynamics. Sedation may also reduce transpulmonary pressure and the associated risk of exposing the patient to high tidal volume hence preventing ventilator-induced lung injury (VILI).
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-08-22 |