chapter  16
12 Pages

Non-invasive ventilation in chronic obstructive pulmonary disease

ByM W Elliott

Mechanically assisted ventilation in COPD 210

Negative pressure ventilation 210

Positive pressure ventilation via tracheostomy 211

Nasal positive pressure ventilation 211

Practical problems specific to patients with COPD 215

Conclusion 216

References 217

Long-term oxygen therapy (LTOT) is the only therapy which has been shown to improve survival in patients with respiratory failure because of chronic obstructive pulmonary disease (COPD).1,2 It is the first-line treatment for such patients, but it is reasonable to explore alternatives. Drug therapy has been disappointing, but with the excellent results of non-invasive positive pressure ventilation (NIV) in patients with neuromuscular disease and chest wall deformity3,4 increasingly attention has focused on the numerically much larger group of patients with COPD. There are a number of theoretical reasons why NIV may confer an additional advantage.