Paper typeMeta-analysis and systematic review
ReferenceLightowler JV, Wedzicha JA, Elliott MW, Ram FSF
Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis.
British Medical Journal 2003; 326:185.
Major FindingNPPV should be the first line intervention in addition to usual medical care to manage respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease in all suitable patients. NPPV should be tried early in the course of respiratory failure and before severe acidosis, to reduce mortality, avoid endotracheal intubation, and decrease treatment failure.
Point for discussion:
Should NIV be considered an extension of 'usual medical care' in exacerbations of COPD?