Mechanical ventilation means having a machine help you
breathe. If you have
COPD, you may need this treatment when your breathing
problems suddenly get worse and stay worse. These breathing attacks are called
COPD exacerbations or flare-ups.
treatment is usually used until you are able to breathe better. In rare cases,
it is used as long-term therapy in your home or a care facility.
There are two kinds of ventilation:
The full name for this is noninvasive positive-pressure ventilation,
sometimes shortened to NPPV. A machine pushes air into your lungs through a
mask that covers your nose or your nose and mouth.
generally is recommended when you're having a very hard time breathing because
of a COPD attack and sudden lung failure.1, 2
Studies show that this treatment:1, 2
But studies also show that people with only mild COPD attacks
aren't helped by this treatment.1
not clear whether this treatment helps people with severe stable COPD. Studies
have shown conflicting results. Some research shows a possible positive
benefit. Other research shows no benefit.3 More study
needs to be done.
People who have very low
blood pressure, are not breathing on their own, and
are not fully able to think and interact with caregivers are not considered
good candidates for this treatment. For them, invasive mechanical ventilation
is considered safer.
In invasive mechanical ventilation, a breathing
tube is inserted into your windpipe, and a machine forces air into your lungs.
Although this can save your life during a COPD attack, it doesn't
always help. Consider talking with your doctor and your family ahead of time
about what kind of treatment you want.
Keenan SP, et al. (2003). Which patients with acute
exacerbations of chronic obstructive pulmonary disease benefit from noninvasive
positive-pressure ventilation? Annals of Internal Medicine, 138: 861–870.
Ram FSF, et al. (2005). Non-invasive
positive pressure ventilation for treatment of respiratory failure due to
exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews (2). Oxford: Update
Wijkstra PJ, et al. (2005). Nocturnal
non-invasive positive pressure ventilation for stable chronic obstructive
disease. Cochrane Database of Systematic Reviews (2).
Oxford: Update Software.
November 29, 2011
E. Gregory Thompson, MD - Internal Medicine
& Ken Y. Yoneda, MD - Pulmonology
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