家用无创通气的适应症和证据。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-27 DOI:10.1080/17476348.2023.2295941
Anita Saigal, Amar J Shah, Swapna Mandal
{"title":"家用无创通气的适应症和证据。","authors":"Anita Saigal, Amar J Shah, Swapna Mandal","doi":"10.1080/17476348.2023.2295941","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Home noninvasive ventilation (HNIV) has expanded globally, with a greater evidence base for its use. HNIV improves multiple patient related outcomes in patients with chronic hypercapnic respiratory failure. Obesity hypoventilation syndrome (OHS) is rapidly taking over as the primary indication for HNIV and COPD patients who overlap with obstructive sleep apnea hypoventilation syndromes (OSAHS) and are increasingly recognized but add to the complexity of HNIV prescribing. Optimal settings vary for differing diseases, with higher inspiratory pressures often required in those with OHS and COPD, yet which settings translate into greatest patient benefit remains unknown.</p><p><strong>Areas covered: </strong>We cover the evidence base underpinning the common indications for HNIV in COPD, OHS, neuromuscular disease (NMD), and chest wall disease (CWD) and highlight common HNIV modes used.</p><p><strong>Expert opinion: </strong>Active screening for nocturnal hypoventilation in OHS and COPD may be important to guide earlier ventilation. Further research on which HNIV modalities best improve patient related outcomes and the right time for initiation in different patient phenotypes is rapidly needed. Worldwide, clinical research trials should aim to bridge the gap by reporting on patient-related outcomes and cost effectiveness in real-world populations to best understand the true benefit of HNIV amongst heterogenous patient populations.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Indications and evidence for domiciliary noninvasive ventilation.\",\"authors\":\"Anita Saigal, Amar J Shah, Swapna Mandal\",\"doi\":\"10.1080/17476348.2023.2295941\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Home noninvasive ventilation (HNIV) has expanded globally, with a greater evidence base for its use. HNIV improves multiple patient related outcomes in patients with chronic hypercapnic respiratory failure. Obesity hypoventilation syndrome (OHS) is rapidly taking over as the primary indication for HNIV and COPD patients who overlap with obstructive sleep apnea hypoventilation syndromes (OSAHS) and are increasingly recognized but add to the complexity of HNIV prescribing. Optimal settings vary for differing diseases, with higher inspiratory pressures often required in those with OHS and COPD, yet which settings translate into greatest patient benefit remains unknown.</p><p><strong>Areas covered: </strong>We cover the evidence base underpinning the common indications for HNIV in COPD, OHS, neuromuscular disease (NMD), and chest wall disease (CWD) and highlight common HNIV modes used.</p><p><strong>Expert opinion: </strong>Active screening for nocturnal hypoventilation in OHS and COPD may be important to guide earlier ventilation. Further research on which HNIV modalities best improve patient related outcomes and the right time for initiation in different patient phenotypes is rapidly needed. Worldwide, clinical research trials should aim to bridge the gap by reporting on patient-related outcomes and cost effectiveness in real-world populations to best understand the true benefit of HNIV amongst heterogenous patient populations.</p>\",\"PeriodicalId\":94007,\"journal\":{\"name\":\"Expert review of respiratory medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert review of respiratory medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/17476348.2023.2295941\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert review of respiratory medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17476348.2023.2295941","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/27 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

导言:家庭无创通气(HNIV)已在全球范围内得到推广,其使用也有了更多的证据基础。HNIV 可改善慢性高碳酸血症呼吸衰竭患者的多种相关预后。肥胖低通气综合征(OHS)正迅速成为 HNIV 的主要适应症,而与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)重叠的慢性阻塞性肺疾病患者也越来越多地被认识到,但这也增加了 HNIV 处方的复杂性。不同疾病的最佳设置各不相同,阻塞性睡眠呼吸暂停低通气综合征和慢性阻塞性肺病患者通常需要更高的吸气压力,但哪种设置能为患者带来最大益处仍是未知数:我们介绍了慢性阻塞性肺病、OHS、神经肌肉疾病(NMD)和胸壁疾病(CWD)中常见的 HNIV 适应症的证据基础,并重点介绍了常用的 HNIV 模式:专家意见:积极筛查 OHS 和 COPD 患者的夜间通气不足对于指导早期通气可能非常重要。目前急需进一步研究哪种 HNIV 模式能最好地改善患者相关预后,以及在不同患者表型中启动通气的正确时间。世界范围内的临床研究试验应旨在通过报告真实人群中与患者相关的疗效和成本效益来缩小差距,从而更好地了解 HNIV 在不同患者人群中的真正益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Indications and evidence for domiciliary noninvasive ventilation.

Introduction: Home noninvasive ventilation (HNIV) has expanded globally, with a greater evidence base for its use. HNIV improves multiple patient related outcomes in patients with chronic hypercapnic respiratory failure. Obesity hypoventilation syndrome (OHS) is rapidly taking over as the primary indication for HNIV and COPD patients who overlap with obstructive sleep apnea hypoventilation syndromes (OSAHS) and are increasingly recognized but add to the complexity of HNIV prescribing. Optimal settings vary for differing diseases, with higher inspiratory pressures often required in those with OHS and COPD, yet which settings translate into greatest patient benefit remains unknown.

Areas covered: We cover the evidence base underpinning the common indications for HNIV in COPD, OHS, neuromuscular disease (NMD), and chest wall disease (CWD) and highlight common HNIV modes used.

Expert opinion: Active screening for nocturnal hypoventilation in OHS and COPD may be important to guide earlier ventilation. Further research on which HNIV modalities best improve patient related outcomes and the right time for initiation in different patient phenotypes is rapidly needed. Worldwide, clinical research trials should aim to bridge the gap by reporting on patient-related outcomes and cost effectiveness in real-world populations to best understand the true benefit of HNIV amongst heterogenous patient populations.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信