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Noninvasive positive pressure ventilation in acute hypercapnic respiratory failure

Abstract

NPPV is well established in the management of acute on chronic hypercapnic respiratory failure secondary to acute exacerbation of COPD (AECOPD), obesity hypoventilation syndrome, and restrictive thoracic disorders. Because of its design, success depends largely on patient cooperation and acceptance. The most commonly used interfaces in acute hypercapnic respiratory failure are oronasal masks. During noninvasive ventilation patients respiratory system is maintained throughout the whole respiratory cycle at a constant pressure higher than the atmospheric pressure, usually termed the positive end-expiratory pressure (PEEP). Pressure support ventilation (PSV), is the most famous mode of partial ventilatory support that during spontaneous inspiratory efforts imposes a set level of positive pressure in a patient with intact respiratory drive. Bilevel positive airway pressure (BiPAP) include PSV during inspiration and EPAP during expiration. The highest pressure reached during inspiration is called inspiratory positive airway pressure (IPAP) which equal PSV + EPAP.

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Correspondence to Khaled Hussein MD.

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Hussein, K. Noninvasive positive pressure ventilation in acute hypercapnic respiratory failure. Egypt J Bronchol 12, 143–148 (2018). https://doi.org/10.4103/ejb.ejb_65_17

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