Nocturnal noninvasive ventilation |
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Authors: | Ozsancak Aylin D'Ambrosio Carolyn Hill Nicholas S |
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Affiliation: | Division of Pulmonary, Critical Care and Sleep Medicine, Tufts-New England Medical Center, 750 Washington St, #257, Boston, MA 02111, USA. |
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Abstract: | Nocturnal noninvasive ventilation (NNV), the provision of ventilatory assistance via a noninvasive interface mainly during sleep, has assumed an important role in the management of chronic hypoventilatory syndromes. This review focuses on recent developments related to the use of NNV to treat various forms of chronic respiratory failure or insufficiency. In the past, NNV has been used mainly to treat respiratory insufficiency in patients with neuromuscular disease (NMD) or chest wall deformity; it should be instituted when these patients have orthopnea or daytime symptoms associated with nocturnal hypoventilation. An emerging application is to treat obesity-hypoventilation syndrome, particularly in continuous positive airway pressure (CPAP) failures. Additionally, it has a role in managing some patients with obstructive sleep apnea who are hypoventilating or find the lower expiratory pressure with bilevel positive pressure ventilators more tolerable than with CPAP alone. NNV to treat severe, stable COPD remains controversial, although a subgroup of patients with hypercapnea and sleep-disordered breathing (SDB) seems most likely to respond favorably. NNV to treat central SDB in patients with congestive heart failure continues to be investigated. Recent findings from a Canadian CPAP trial were disappointing, but preliminary results on a novel adaptive NNV mode are promising. |
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Keywords: | chronic respiratory failure neuromuscular disease nocturnal noninvasive ventilation obesity hypoventilation syndrome sleep-disordered breathing AHI" },{" #name" :" keyword" ," $" :{" id" :" cekeyw70" }," $$" :[{" #name" :" text" ," _" :" apnea-hypopnea index ALS" },{" #name" :" keyword" ," $" :{" id" :" cekeyw90" }," $$" :[{" #name" :" text" ," _" :" amyotrophic lateral sclerosis APAP" },{" #name" :" keyword" ," $" :{" id" :" cekeyw110" }," $$" :[{" #name" :" text" ," _" :" autotitrating positive airway pressure ASV" },{" #name" :" keyword" ," $" :{" id" :" cekeyw130" }," $$" :[{" #name" :" text" ," _" :" adaptive servoventilation CHF" },{" #name" :" keyword" ," $" :{" id" :" cekeyw150" }," $$" :[{" #name" :" text" ," _" :" congestive heart failure CPAP" },{" #name" :" keyword" ," $" :{" id" :" cekeyw170" }," $$" :[{" #name" :" text" ," _" :" continuous positive airway pressure NIV" },{" #name" :" keyword" ," $" :{" id" :" cekeyw190" }," $$" :[{" #name" :" text" ," _" :" noninvasive ventilation NMD" },{" #name" :" keyword" ," $" :{" id" :" cekeyw210" }," $$" :[{" #name" :" text" ," _" :" neuromuscular disease NNV" },{" #name" :" keyword" ," $" :{" id" :" cekeyw230" }," $$" :[{" #name" :" text" ," _" :" nocturnal noninvasive ventilation OHS" },{" #name" :" keyword" ," $" :{" id" :" cekeyw250" }," $$" :[{" #name" :" text" ," _" :" obesity-hypoventilation syndrome OSA" },{" #name" :" keyword" ," $" :{" id" :" cekeyw270" }," $$" :[{" #name" :" text" ," _" :" obstructive sleep apnea PAP" },{" #name" :" keyword" ," $" :{" id" :" cekeyw290" }," $$" :[{" #name" :" text" ," _" :" positive airway pressure REM" },{" #name" :" keyword" ," $" :{" id" :" cekeyw310" }," $$" :[{" #name" :" text" ," _" :" rapid eye movement SDB" },{" #name" :" keyword" ," $" :{" id" :" cekeyw330" }," $$" :[{" #name" :" text" ," _" :" sleep-disordered breathing |
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