Farmer MJS, Callahan CD, Hughes AM, Riska KL, Hill NS. Applying Noninvasive Ventilation in Treatment of Acute Exacerbation of COPD Using Evidence-Based Interprofessional Clinical Practice.
Chest 2024;
165:1469-1480. [PMID:
38417700 PMCID:
PMC11177098 DOI:
10.1016/j.chest.2024.02.040]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024] Open
Abstract
When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to COPD exacerbation in conjunction with guideline-recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines. Identifying patients appropriate for NIV, and subsequently providing close monitoring to determine an improvement in clinical condition involves a team consisting of physician, nurse, and respiratory therapist in institutions that successfully implement NIV. We describe to our knowledge the first known evidence-based algorithm speaking to initiation, titration, monitoring, and weaning of NIV in treatment of acute exacerbation of COPD that incorporates the necessary interprofessional collaboration among physicians, nurses, and respiratory therapists caring for these patients.
Collapse