Treatment of respiratory failure in COPD
Stephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicin...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2008-12-01
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| Series: | International Journal of COPD |
| Online Access: | http://www.dovepress.com/treatment-of-respiratory-failure-in-copd-a2685 |
| _version_ | 1811287234995814400 |
|---|---|
| author | Stephan Budweiser Rudolf A Jörres Michael Pfeifer |
| author_facet | Stephan Budweiser Rudolf A Jörres Michael Pfeifer |
| author_sort | Stephan Budweiser |
| collection | DOAJ |
| description | Stephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, GermanyAbstract: Patients with advanced COPD and acute or chronic respiratory failure are at high risk for death. Beyond pharmacological treatment, supplemental oxygen and mechanical ventilation are major treatment options. This review describes the physiological concepts underlying respiratory failure and its therapy, as well as important treatment outcomes. The rationale for the controlled supply of oxygen in acute hypoxic respiratory failure is undisputed. There is also a clear survival benefit from long-term oxygen therapy in patients with chronic hypoxia, while in mild, nocturnal, or exercise-induced hypoxemia such long-term benefits appear questionable. Furthermore, much evidence supports the use of non-invasive positive pressure ventilation in acute hypercapnic respiratory failure. It application reduces intubation and mortality rates, and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failure became a major indication for domiciliary mechanical ventilation, based on pathophysiological reasoning and on data regarding symptoms and quality of life. Still, however, its relevance for long-term survival has to be substantiated in prospective controlled studies. Such studies might preferentially recruit patients with repeated hypercapnic decompensation or a high risk for death, while ensuring effective ventilation and the patients’ adherence to therapy.Keywords: respiratory failure, COPD, mechanical ventilation, non-invasive ventilation long-term oxygen therapy, chronic hypercapnic respiratory failure, oxygen |
| first_indexed | 2024-04-13T03:15:08Z |
| format | Article |
| id | doaj.art-45b7c64e631f481fb242dd1c384dcf7d |
| institution | Directory Open Access Journal |
| issn | 1176-9106 1178-2005 |
| language | English |
| last_indexed | 2024-04-13T03:15:08Z |
| publishDate | 2008-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-45b7c64e631f481fb242dd1c384dcf7d2022-12-22T03:04:56ZengDove Medical PressInternational Journal of COPD1176-91061178-20052008-12-012008Issue 4605618Treatment of respiratory failure in COPDStephan BudweiserRudolf A JörresMichael PfeiferStephan Budweiser1, Rudolf A Jörres2, Michael Pfeifer1,31Center for Pneumology, Hospital Donaustauf, Donaustauf, Germany; 2Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; 3Department of Internal Medicine II, Division of Respirology, University of Regensburg, Regensburg, GermanyAbstract: Patients with advanced COPD and acute or chronic respiratory failure are at high risk for death. Beyond pharmacological treatment, supplemental oxygen and mechanical ventilation are major treatment options. This review describes the physiological concepts underlying respiratory failure and its therapy, as well as important treatment outcomes. The rationale for the controlled supply of oxygen in acute hypoxic respiratory failure is undisputed. There is also a clear survival benefit from long-term oxygen therapy in patients with chronic hypoxia, while in mild, nocturnal, or exercise-induced hypoxemia such long-term benefits appear questionable. Furthermore, much evidence supports the use of non-invasive positive pressure ventilation in acute hypercapnic respiratory failure. It application reduces intubation and mortality rates, and the duration of intensive care unit or hospital stays, particularly in the presence of mild to moderate respiratory acidosis. COPD with chronic hypercapnic respiratory failure became a major indication for domiciliary mechanical ventilation, based on pathophysiological reasoning and on data regarding symptoms and quality of life. Still, however, its relevance for long-term survival has to be substantiated in prospective controlled studies. Such studies might preferentially recruit patients with repeated hypercapnic decompensation or a high risk for death, while ensuring effective ventilation and the patients’ adherence to therapy.Keywords: respiratory failure, COPD, mechanical ventilation, non-invasive ventilation long-term oxygen therapy, chronic hypercapnic respiratory failure, oxygenhttp://www.dovepress.com/treatment-of-respiratory-failure-in-copd-a2685 |
| spellingShingle | Stephan Budweiser Rudolf A Jörres Michael Pfeifer Treatment of respiratory failure in COPD International Journal of COPD |
| title | Treatment of respiratory failure in COPD |
| title_full | Treatment of respiratory failure in COPD |
| title_fullStr | Treatment of respiratory failure in COPD |
| title_full_unstemmed | Treatment of respiratory failure in COPD |
| title_short | Treatment of respiratory failure in COPD |
| title_sort | treatment of respiratory failure in copd |
| url | http://www.dovepress.com/treatment-of-respiratory-failure-in-copd-a2685 |
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