Extubating to Noninvasive Ventilation : Noninvasive Ventilation from Intensive Care Unit to Home - 29/10/20

Doi : 10.1016/j.jsmc.2020.08.010

Ashima S. Sahni, MD ^a,^⁎ , Lien-Khuong Tran, MD ^b, Lisa F. Wolfe, MD ^c
^a Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3135 (MC 719), Chicago, IL 60612, USA
^b Pulmonary, Critical Care and Sleep, Texas Pulmonary & Critical Care Consultants, 1201 Fairmount Avenue, Fort Worth, TX 76104, USA
^c Department of Pulmonary and Critical Care, Northwestern University, 675 North Saint Clair Street, 14 th floor Pulmonary Medicine, Chicago, Illinois 60611, USA

^∗Corresponding author.

Résumé

Weaning to noninvasive ventilation in intensive care unit and bridging the patients to home with respiratory support is evolving as the technology of noninvasive ventilation is improving. In patients with chronic obstructive pulmonary disease exacerbation, timing of initiation of noninvasive ventilation is the key, as persistently hypercapnic patients show benefits. High-intensity pressure support seems to do better in comparison to low-intensity pressure support. In patients with obesity and hypercapnia, obesity hypoventilation cannot be ruled out especially in an inpatient setting, and it is crucial that these patients are discharged with noninvasive ventilation.

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Keywords : Weaning, Home respiratory care, Noninvasive ventilation, Acute respiratory failure, Hypercapnia