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The savior of COPD: Why is non-invasive ventilation so important?
With the rapid development of today's medical technology, non-invasive ventilation (NIV), as an important respiratory support method, has become a key choice for the treatment of chronic obstructive pulmonary disease (COPD). NIV uses devices such as masks, nasal masks or helmets to provide support and deliver air and oxygen to the patient's lungs with positive pressure, allowing them to receive necessary respiratory support without the need for intubation.
The application of non-invasive ventilation technology can significantly reduce the need for invasive ventilation and improve acute respiratory failure caused by diseases such as COPD. Studies show that appropriate use of NIV reduces the chance that patients will need invasive ventilation and the associated risk of complications.
Non-invasive ventilation is not only suitable for acute conditions, but can also be used long-term when the patient is unable to breathe on his own.
Medical applications of non-invasive ventilation
Non-invasive ventilation is particularly important in the treatment of acute respiratory failure, especially in patients with exacerbations of chronic obstructive pulmonary disease, as well as other acute conditions such as acute heart failure. NIV can be used not only for acute attacks, but also for long-term management. Some patients may require long-term use of NIV at home after acute respiratory failure.
During the COVID-19 epidemic, in the face of a shortage of invasive ventilation equipment, the use of NIV has attracted more attention. Although caregivers need to be fully protected to prevent the risk of aerosol release, NIV still provides a feasible respiratory support solution.
Acute exacerbations of chronic obstructive pulmonary disease are the most common indication for non-invasive ventilation.
COPD and NIV
It is quite common for patients with COPD to require non-invasive ventilation during an exacerbation. Doctors will decide whether to start NIV based on the response to medication and the results of arterial blood gas examination. If despite medical treatment, the patient is still unable to effectively remove carbon dioxide from the bloodstream (respiratory acidosis), NIV therapy may need to be started.
Many patients with COPD typically have elevated carbon dioxide levels that have metabolic compensation, but initiation of NIV is appropriate only if the carbon dioxide rises sharply, resulting in an increase in blood acidity levels (pH <7.35). Although there is no clear upper limit for acidity, the more severe the acidosis symptoms are, the less likely success of NIV alone will be.
Other causes of acute respiratory failure
In addition to COPD, bronchiectasis, neuromuscular diseases, obesity and hypoventilation, etc. may also cause acute respiratory failure. People who cannot breathe independently may also need NIV support. In some cases, NIV may be initiated even in the absence of acidosis, particularly in patients with daytime somnolence or sleep disorders.
Chronic use of NIV can improve daytime hypercapnia in patients with stable chronic obstructive pulmonary disease.
Long-term use and home care
For patients with severe COPD, long-term use of NIV ("home NIV") may be an appropriate option. Studies have shown that long-term use of NIV can improve patients' health-related quality of life and may even improve survival rates. In addition to COPD, patients with neuromuscular diseases often need to use home NIV to maintain respiratory performance during the course of the disease.
In the COVID-19 epidemic, the application of NIV is not limited to acute illnesses, but has also become an important treatment option for patients at home.
Future Outlook
With the further development of non-invasive ventilation technology and the popularization of related equipment, future treatment directions may move towards more refined and personalized solutions. How to apply NIV more effectively under different conditions will be an important issue in medical research and clinical practice.
When facing the challenges of chronic obstructive pulmonary disease, the use of non-invasive ventilation is not only related to the patient's survival, but also affects their quality of life and self-confidence. In the future, how to further improve the efficacy of NIV and adjust it according to different patient characteristics will be an urgent issue for us to think about.
