Non-invasive ventilation (NIV) is one of the most important developments in pulmonology over the past 15 years. Physiologic effect of NIV is the same as that of invasive ventilation and consists of unloading respiratory muscles and improving oxygenation. Nevertheless avoidance of ominous complications of intubation gives important advantages of NIV over invasive ventilation. The principal indication for NIV is severe exacerbation of COPD, with uncompensated respiratory acidosis. The efficacy of NIV in such population was proved, in controlled trials, to reduce: in-hospital mortality, the need for intubation, the rate of complications and the length of stay in ICU and hospital. The role of NIV in the treatment of COPD patients in stable state is less evident. However, there are several theoretical reasons and clinical evidences to use NIV in home setting in patients with severe hypercapnia and symptoms of hypoventilation, in individuals who failed long-term oxygen therapy (LTOT) treatment and in subjects with recurrent exacerbations. Moreover, NIV in acute and chronic setting was recognized as cost-effective treatment.
Pneumonol. Alergol. Pol. 2011; 79, 3: 246-252