Ventilação mecânica não invasiva no desmame de pacientes com doença pulmonar obstrutiva crônica

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is characterized by chronic airflow limitation. The therapeutic goals related to invasive mechanical ventilation in COPD are: to promote respiratory muscle rest, minimize lung hyperinflation, improve gas exchange and, in particular, ensure alveolar ventilation, correcting respiratory acidosis, if present, facilitate the resolution of underlying cause of acute exacerbation; enable the aspiration of tracheobronchial secretions; enable sleep; optimize the treatment of COPD. The use of noninvasive ventilation (NIV) for the treatment of patients with acute respiratory failure or acute on chronic has been used as first choice treatment for patients with COPD exacerbation. We conducted a literature review on Medline, SciELO, PubMed, Cochrane, with the key terms: Chronic obstructive pulmonary disease (COPD), noninvasive ventilation (NIV) and weaning.We found a total of 13 articles out of which 5 were randomized controlled clinical trial, two meta-analysis and review SiteMat, three prospective observational study and three review articles. The results of this review show that the use of NIV compared with standard therapy decreased the rate of reintubation and ICU mortality, but the follow up that had not reduced the rate of hospital mortality. This study suggests that the use of NIV should follow a carefully specified with protocol in patients after extubation, especially for those with respiratory failure