B Schönhofer1, R Kuhlen, P Neumann, M Westhoff, C Berndt, H Sitter. 1. Abteilung für Pneumologie und internistische Intensivmedizin, Krankenhaus Oststadt - Heidehaus, Klinikum Region Hannover, Podbielskistr. 380, 30659 Hannover, Deutschland. Bernd.Schoenhofer@t-online.de
Abstract
BACKGROUND: Scientific evidence is accumulating that non-invasive ventilation (NIV) may be beneficial for different patient groups with acute respiratory insufficiency (ARI). The aim of the new S3 guidelines is to propagate evidence-based knowledge about the indications and limitations of NIV in clinical practice. METHODS: A total of 28 experts from 12 German medical societies were involved in the process of development of the present guidelines. These experts systematically analyzed approximately 2,900 publications. Finally, the recommendations were discussed and approved in two consensus conferences. RESULTS: In hypercapnic ARI, NIV reduces the length of stay and mortality during intensive care treatment [grade A recommendation (A)]. Patients with cardiopulmonary edema should be treated with continuous positive airway pressure (CPAP) or NIV (A). For immunocompromized patients with ARI, NIV reduces the mortality (A). In patients with postextubation respiratory failure and during weaning from mechanical ventilation, NIV reduces the risk of reintubation (A). For patients who decline to be ventilated invasively, NIV may be an acceptable alternative (B). Non-invasive ventilation can also successfully be used in pediatric patients with ARI caused by different reasons (C). In acute respiratory distress syndrome (ARDS) NIV cannot generally be recommended because the failure rate is relatively high. CONCLUSION: Non-invasive ventilation is still not as widely implemented in clinical medicine as would be expected on the basis of the scientific literature. The aim of the present guidelines is to further propagate NIV for the treatment of ARI.
BACKGROUND: Scientific evidence is accumulating that non-invasive ventilation (NIV) may be beneficial for different patient groups with acute respiratory insufficiency (ARI). The aim of the new S3 guidelines is to propagate evidence-based knowledge about the indications and limitations of NIV in clinical practice. METHODS: A total of 28 experts from 12 German medical societies were involved in the process of development of the present guidelines. These experts systematically analyzed approximately 2,900 publications. Finally, the recommendations were discussed and approved in two consensus conferences. RESULTS: In hypercapnic ARI, NIV reduces the length of stay and mortality during intensive care treatment [grade A recommendation (A)]. Patients with cardiopulmonary edema should be treated with continuous positive airway pressure (CPAP) or NIV (A). For immunocompromized patients with ARI, NIV reduces the mortality (A). In patients with postextubation respiratory failure and during weaning from mechanical ventilation, NIV reduces the risk of reintubation (A). For patients who decline to be ventilated invasively, NIV may be an acceptable alternative (B). Non-invasive ventilation can also successfully be used in pediatric patients with ARI caused by different reasons (C). In acute respiratory distress syndrome (ARDS) NIV cannot generally be recommended because the failure rate is relatively high. CONCLUSION: Non-invasive ventilation is still not as widely implemented in clinical medicine as would be expected on the basis of the scientific literature. The aim of the present guidelines is to further propagate NIV for the treatment of ARI.
Authors: Karim Chadda; Djillali Annane; Nicholas Hart; Philippe Gajdos; Jean Claude Raphaël; Frédéric Lofaso Journal: Crit Care Med Date: 2002-11 Impact factor: 7.598
Authors: Sean P Keenan; Tasnim Sinuff; Karen E A Burns; John Muscedere; Jim Kutsogiannis; Sangeeta Mehta; Deborah J Cook; Najib Ayas; Neill K J Adhikari; Lori Hand; Damon C Scales; Rose Pagnotta; Lynda Lazosky; Graeme Rocker; Sandra Dial; Kevin Laupland; Kevin Sanders; Peter Dodek Journal: CMAJ Date: 2011-02-14 Impact factor: 8.262
Authors: V Mann; S Mann; G Szalay; M Hirschburger; R Röhrig; C Dictus; T Wurmb; M A Weigand; M Bernhard Journal: Anaesthesist Date: 2010-08 Impact factor: 1.041
Authors: Hans Jörg Baumann; Hans Klose; Marcel Simon; Tarik Ghadban; Stephan A Braune; Jan K Hennigs; Stefan Kluge Journal: Crit Care Date: 2011-07-27 Impact factor: 9.097
Authors: Jessica Morales-Ortíz; Matthew T Rondina; Samuel M Brown; Colin Grissom; A Valance Washington Journal: Clin Appl Thromb Hemost Date: 2018-05-14 Impact factor: 2.389