Ventilação não invasiva
Non-invasive ventilation
Susana Ferreira1,, , Carla Nogueira1, Sara Conde2, Natália Taveira3, Bárbara Parente4
1 Interna Complementar de Pneumologia
2 Assistente Hospitalar de Pneumologia
3 Assistente Hospitalar Graduada de Pneumologia
4 Centro Hospitalar de Vila Nova de Gaia / Espinho EPE – Porto, Portugal
Received 26 November 2008, Accepted 06 February 2009
Resumo

A ventilação não invasiva (VNI) consiste na aplicação de um suporte ventilatório sem recorrer a métodos invasivos, evitando desta forma as complicações associadas à entubação orotraqueal e ventilação mecânica invasiva. Esta técnica já demonstrou ser eficaz em diversos tipos de insuficiência respiratória aguda ou crónica agudizada. Neste artigo, os autores fazem uma revisão dos benefícios, vantagens e limitações da VNI, interfaces utilizadas e principais indicações desta técnica na insuficiência respiratória aguda (IRA) e na insuficiência respiratória crónica agudizada.

Abstract

Non-invasive ventilation (NIV) is a technique that delivers mechanical ventilation avoiding side effects and complications associated with endotracheal intubation and invasive mechanical ventilation. This technique has proved to be effective in different types of respiratory failure. In this article, the authors revise the advantages and limitations of NIV, interfaces used and indications in acute and acute-on-chronic respiratory failure.

Palavras-chave
Ventilação não invasiva, insuficiência respiratória, edema agudo do pulmão, doenças pulmonares obstrutivas, asma, bronquiectasias, fibrose quística, entubação orotraqueal
Key-words
Noninvasive ventilation, respiratory failure, pulmonary edema, obstructive lung diseases, asthma, bronchiectasis, cystic fibrosis, endotracheal intubation
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Bibliografia
1.
N. Ambrosino,G. Vagheggini
Noninvasive positive pressure ventilation in the acute care setting: Where are we?
Eur Respir J, 31 (2008), pp. 874-886
2.
P.K. Plant,J.L. Owen,M.W. Ellliot
Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomized controlled trial
Lancet, 355 (2000), pp. 1931-1935
3.
International Consensus Conference in Intensive Care Medicine
Non-invasive ventilation in acute respiratory failure
Am J Respir Crit Care Med, 163 (2001), pp. 238-291
4.
M. Antonelli,M.A. Pennisi,L. Montiniet
Clinical review: Noninvasive ventilation in the clinical setting – experience from the past 10 years
Critical Care, 9 (2005), pp. 98-103
5.
A.D. Bersten,A.W. Holt,A.E. Vedig,G.A. Skowronski,C.J. Baggoley
Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure delivered by face mask
N Engl J Med, 325 (1991), pp. 1825-1830
6.
M. Lin,Y.F. Yang,H.T. Chiang,M.S. Chang,B.N. Chiang,M.D. Cheitlin
Reappraisal of continuous positive airway pressure therapy in acute cardiogenic pulmonary edema: short term results and long term follow up
Chest, 107 (1995), pp. 1379-1386
7.
J. Rasanen,J. Heikkila,J. Downs
Continuous positive airways pressure by face mask in acute cardiogenic pulmonary edema
Am J Cardiol, 55 (1985), pp. 296-300
8.
T. Rusterholtz,J. Kempf,C. Berton
Noninvasive pressure support ventilation (NIPSV) with face mask in patients with acute cardiogenic pulmonary edema (ACPO)
Intensive Care Med, 25 (1999), pp. 21-28
9.
B. Hoffmann,T. Welte
The use of non-invasive pressure support ventilation for severe respiratory insufficiency due to pulmonary edema
Intensive Care Med, 25 (1999), pp. 15-20
10.
S. Mehta,G.D. Jay,R.H. Woolard
Randomized prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema
Crit Care Med, 25 (1997),
11.
J.V. Peter,J.L. Moran,J. Phillips-Hughes,P. Graham,A.D. Bersten
Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis
Lancet, 367 (2006), pp. 1155-1163
12.
M. Antonelli,G. Conti,M. Bufi
Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial
JAMA, 283 (2000), pp. 235-241
13.
G. Hilbert,D. Gruson,F. Vargas
Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever and acute respiratory failure
N Engl J Med, 344 (2001), pp. 481-487
14.
M. Confalonieri,E. Calderini,S. Terraciano
Noninvasive ventilation for treating acute respiratory failure in AIDS patients with Pneumocystis carinii pneumonia
Intensive Care Med, 28 (2002), pp. 1233-1238
15.
P.O. Depuydt,D.D. Benoit,K.H. Vandewoude,J.M. Decruyenaere,F.A. Colardyn
Outcome in noninvasively and invasively ventilated hematologic patients with acute respiratory failure
Chest, 126 (2004), pp. 1299-1306
16.
G.U. Meduri,T.R. Cook,R.E. Turner,M. Cohen,K.V. Leeper
Noninvasive positive pressure ventilation in satus asthmaticus
Chest, 110 (1996), pp. 767-774
17.
M.M. Fernandez,A. Villagra,L. Blanch,R. Fernandez
Noninvasive mechanical ventilation in status asthmaticus
Intensive Care Med, 27 (2001), pp. 486-492
18.
M. Confalonieri,A. Potena,G. Carbone,R.D. Porta,E.A. Tolley,G.U. Meduri
Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation
Am J Respir Crit Care Med, 160 (1999), pp. 1585-1591
19.
M. Ferrer,A. Esquinas,M. Leon,G. Gonzalez,A. Alarcon,A. Torres
Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized controlled trial
Am J Respir Crit Care Med, 168 (2003), pp. 1438-1444
20.
T. Honrubia,F.J. Garcia López,N. Franco
Noninvasive versus conventional mechanical ventilation in acute respiratory failure. A multicenter, randomized controlled trial
Chest, 128 (2005), pp. 3916-3924
21.
R. Agarwal,C. Reddy,A.N. Aggarwal,D. Gupta
Is there a role for noninvasive ventilation in acute respiratory distress syndrome?. A meta-analysis
Respir Med, 100 (2006), pp. 2235-2238
22.
M. Antonelli,G. Conti,A. Esquinas
A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome
Crit Care Med, 35 (2007), pp. 18-25
23.
S.K. Epstein
Predicting extubation failure: Is it in (on) the cards?
Chest, 120 (2001), pp. 1061-1063
24.
S. Nava,C. Gregoretti,F. Fanfulla,E. Squadrone,M. Grassi,A. Carlucci
Noninvasive ventilation to prevent respiratory failure after extubation in high risk patients
Crit Care Med, 33 (2005), pp. 2465-2470
25.
M. Ferrer,M. Valencia,J.M. Nicolas,O. Bernadich,J.R. Badia,A. Torres
Early non-invasive ventilation averts extubation failure n patients at risk. A randomized trial
Am J Respir Crit Care Med, 15 (2006), pp. 64-70
26.
S.P. Keenan,C. Powers,D.G. McCormack,G. Block
Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial
JAMA, 287 (2002), pp. 3238-3244
27.
A. Esteban,F. Frutos-Vivar,N.D. Ferguson,Y. Arabi,C. Apezteguia,M. Gonzales
Non-invasive positive pressure ventilation for respiratory failure after extubation
N Engl J Med, 350 (2004), pp. 2452-2460
28.
S. Nava,N. Ambrosino,E. Clini,M. Prato,G. Orlando,M. Vitacca
Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial
Ann Intern Med, 128 (1998), pp. 721-728
29.
C. Girault,I. Daudenthun,V. Chevron,F. Tamion,J. Leroy,G. Bonmarchand
Noninvasive ventilation as a systematic extubation and weaning technique in acute-on-chronic respiratory failure. A prospective, randomized, controlled study
Am J Respir Crit Care Med, 160 (1999), pp. 86-92
30.
M. Ferrer,A. Esquinas,F. Arancibia,T.T. Bauer,G. Gonzalez,A. Carrilo
Noninvasive ventilation during persistent weaning failure: a randomized controlled trial
Am J Respir Crit Care Med, 168 (2003), pp. 70-76
31.
K.E. Burns,N.K. Adhikari,M.O. Meade
A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation
Can J Anaesth, 53 (2006), pp. 305-315
32.
M. Levy,M.A. Tanios,D. Nelson,K. Short,A. Senechia,J. Vespia,N.S. Hill
Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation
Crit Care Med, 32 (2004), pp. 2002-2007
33.
G. Schettino,N. Altobelli,R.M. Kacmarek
Noninvasive positive pressure ventilation reverses acute respiratory failure in selected “do-not-intubate” patients
Crit Care Med, 33 (2005), pp. 1976-1982
34.
C.-M. Chu,V.L. Chan,I.W.Y. Wong,W. Leung,A.W.N. Lin,K.-F. Cheung
Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation
Crit Care Med, 32 (2004), pp. 372-377
35.
A. Cuomo,M. Delmastro,P. Ceriana
Noninvasive mechanical ventilation as a palliative treatment of acute respiratory failure in patients with end-stage solid cancer
Pall Med, 18 (2004), pp. 602-610
36.
British Thoracic Society Standards of Care Committee
Noninvasive ventilation in acute respiratory failure
Thorax, 57 (2002), pp. 192-211
37.
T.R. Martin,S.W. Lewis,R.K. Albert
The prognosis of patients with chronic obstructive pulmonary disease after hospitalization for acute respiratory failure
Chest, 82 (1982), pp. 310-314
38.
A. Torres,R. Aznar,J.M. Gatell,P. Jiménez,J. González,A. Ferrer
Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients
Am Rev Respir Dis, 142 (1990), pp. 523-528
39.
J.Y. Fagon,J. Chastre,A.J. Hance,P. Montravers,A. Novara,C. Gibert
Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay
Am J Med, 94 (1993), pp. 281-288
40.
Bradley S. Quon,Qi Gan Wen,Don D. Sin
Contemporary management of acute exacerbations of COPD – systematic review and meta-analysis
Chest, 133 (2008), pp. 756-766
41.
G. Conti,M. Antonelli,P. Navalesi
Noninvasive versus conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial
Int Care Med, 28 (2002), pp. 1701-1707
42.
J.V. Lightowler,J.A. Wedzicha,M.W. Elliot,F.S. Ram
Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis
BMJ, 326 (2003), pp. 185-189
43.
J.S. Balami,S.M. Packham,M.A. Gosney
Non-invasive ventilation for respiratory failure due to acute exacerbations of chronic obstructive pulmonary disease in older patients
Age Ageing, 35 (2006), pp. 75-78
44.
R. Scala,M. Naldi,I. Archinucci,G. Coniglio,S. Nava
Noninvasive positive pressure ventilation in patients with acute exacrbations of COPD and varying levels of consciousness
Chest, 128 (2005), pp. 1657-1666
45.
R. Scala,S. Nava,G. Conti
Noninvasive versus conventional ventilation to treat hypercapnic encephalopathy in chronic obstructive pulmonary disease
Intensive Care Med, 33 (2007), pp. 2101-2108
46.
M.E. Hodson,B.P. Madden,M.H. Steven
Non-invasive mechanical ventilation for cystic fibrosis patients – a potential bridge to transplantation
Eur Respir J, 4 (1991), pp. 524-527
47.
C.G. Caronia,P. Silver,C. Nimkoff,J. Gorvoy,C. Quinn,M. Sagy
Use of bilevel positive airway pressure (BIPAP) in end-stage patients with cystic fibrosis awaiting lung transplantation
Clin Pediatr, 37 (1998), pp. 555-559
48.
A.T. Hill,F.P. Edenborough,R.M. Cayton
Long-term nasal intermittent positive pressure ventilation in patients with cystic fibrosis and hypercapnic respiratory failure
Respir Med, 92 (1998), pp. 523-526
49.
B.P. Madden,H. Kariyawasam,A.J. Siddiqi,A. Machin,J.A. Pryor,M.E. Hodson
Noninvasive ventilation in cystic fibrosis patients with acute or chronic respiratory failure
Eur Respir J, 19 (2002), pp. 310-313
50.
C. Robino,C. Faisy,J.L. Diehl
Effectiveness of non-invasive positive pressure ventilation differs between decompensated chronic restrictive and obstructive pulmonary disease patients
Int Care Med, 29 (2003), pp. 603-610
51.
S. Nava,P. Ceriane
Causes of faillure of noninvasive mechanical ventilation
Respir Care, 49 (2004), pp. 295-303
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