The Use of Non-Invasive Mechanical Ventilation (NIV) in the Prevention of Intubation in Patients with Chronic Obstructive Pulmonary Disease (COPD)
DOI:
https://doi.org/10.62827/fb.v26i4.1072Keywords:
Physical Therapy Department; Noninvasive Ventilation; Pulmonary Disease.Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) affects approximately 17% of the Brazilian population, with an even higher prevalence among patients over the age of 40. Smoking is responsible for 30% to 40% of cases in low- and middle-income countries, while workers exposed to high levels of toxic gases, such as in charcoal kilns and boilers, also have a considerably high risk. Continued exposure to these harmful substances substantially increases the likelihood of developing serious respiratory diseases and other health complications. Objective: To review the use of noninvasive mechanical ventilation (NIV) in preventing orotracheal intubation in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: This is an integrative review of randomized clinical trials, observational studies, and systematic reviews published in the Latin American and Caribbean Literature in Health Sciences (LILACS), American Service of the National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO), Physiotherapy Evidence Database (PEDro) over the last 10 years (2015-2025). Results: NIV significantly reduces the need for orotracheal intubation, length of hospital stay, and mortality. The data also suggest improvements in clinical parameters and arterial blood gases. Conclusion: Studies have shown that interventions using noninvasive ventilation can reduce both hospital stay and the need for orotracheal intubation. Despite the scarcity of studies, the available evidence suggests that these interventions not only improve symptoms but also have a positive impact on the clinical and functional condition of patients.
References
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Estratégia global para diagnóstico, gestão e prevenção da DPOC – Relatório 2024 [Internet]. 2024 [cited 2024 Nov 14]. Available from: https://www.goldcopd.org
Conselho Federal de Farmácia. Pico de fluxo expiratório. Brasília: Conselho Federal de Farmácia; 2020. Available from: https://www.cff.org.br/userfiles/pico_de_fluxo.pdf
Vásconez-González J, Delgado-Moreira K, López-Molina B, Izquierdo-Condoy JS, Gámez-Rivera E, Ortiz-Prado E. Effects of smoking marijuana on the respiratory system: a systematic review. Subst Abus. 2023;44(3):249–60. Available from: https://pubmed.ncbi.nlm.nih.gov/37728136/
Celli BR, Wedzicha JA. Update on Clinical Aspects of Chronic Obstructive Pulmonary Disease. N Engl J Med. 2019;381(13):1257–66. Available from: https://pubmed.ncbi.nlm.nih.gov/31553837/
Osadnik CR, Tee VS, Carson-Chahhoud KV, Picot J, Wedzicha JA, Smith BJ. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2017;7:CD004104. Available from: https://pubmed.ncbi.nlm.nih.gov/28702957/
Lu HY, Tang L, Chen X, Chen R. Effects of early pulmonary rehabilitation on hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2023;18:881–93. Available from: https://pubmed.ncbi.nlm.nih.gov/37215744/
Sehgal IS, Dhooria S, Agarwal R, Prasad KT, Muthu V, Aggarwal AN. A randomized controlled trial of noninvasive ventilation with pressure support ventilation and adaptive support ventilation in acute exacerbation of COPD: a feasibility study. COPD. 2019;16(2):168–73. Available from: https://pubmed.ncbi.nlm.nih.gov/31161812/
Tan D, et al. High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: a randomized controlled non-inferiority trial. Crit Care. 2024;28(1). Available from: https://doi:10.1186/s13054-024-05040-9
Wang SM, Li Y, Li YJ, Zhu XQ, Pan J, Li YX. Epidemiology and issues of NIV-treated AECOPD patients with hypercapnic respiratory failure in Shanghai: a multicentre retrospective survey. Clin Respir J. 2021;15(5):550–7. Available from: https://doi.org/10.1111/crj.13311
Ambrosino N, Bertella E. Lifestyle interventions in prevention and comprehensive management of COPD. Breathe (Sheff). 2018;14(3):186–94. Available from: https://doi.org/10.1183/20734735.0186-18
Associação de Medicina Intensiva Brasileira (AMIB), Sociedade Brasileira de Pneumologia e Tisiologia (SBPT). DOC: orientações práticas em ventilação mecânica. São Paulo: AMIB/SBPT; 2024 Sep. Available from: https://sbpt.org.br/portal/amib-sbpt-lancam-edicao-atualizada-orientacoes-praticas-em-ventilacao-mecanica/
Camargo LAC da R, Castellano MVO, Ferreira FC, Faria FV de, Carvas N. Hospitalization due to exacerbation of COPD: "Real-life" outcomes. Rev Assoc Med Bras. 2017;63(6):543–9. Available from: https://doi.org/10.1590/1806-9282.63.06.543
Cruz MM, Pereira M. Epidemiology of chronic obstructive pulmonary disease in Brazil: a systematic review and meta-analysis. Cienc Saude Colet. 2020;25(11):4239–49. Available from: https://doi.org/10.1590/1413-812320202511.00222019
Dabscheck E, Wood-Baker R, McDonald CF, Yang IA. COPD-X Australian guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2022 update. Med J Aust. 2022;217(8):415–23. Available from: https://doi.org/10.5694/mja2.51708
Delmas MC, Pasquereau A, Renuy A, Bénézet L, Ribet C, Zins M, et al. Electronic cigarette use and respiratory symptoms in the French population-based Constances cohort. Respir Med. 2024;221:107496. Available from: https://doi.org/10.1016/j.rmed.2023.107496
Gupta N, Pinto LM, Morogan A, Bourbeau J. The COPD assessment test: a systematic review. Eur Respir J. 2014;44(4):873–84. Available from: https://pubmed.ncbi.nlm.nih.gov/24993906/
He W, Wang J, Feng Z, Li J, Xie Y. Effects of exercise-based pulmonary rehabilitation on severe/very severe COPD: a systematic review and meta-analysis. Ther Adv Respir Dis. 2023;17:17534666231162250. Available from: https://pubmed.ncbi.nlm.nih.gov/36946384/
Hess DR. Respiratory care management of COPD exacerbations. Respir Care. 2023;68(6):821–37. Available from: https://pubmed.ncbi.nlm.nih.gov/37225653/
MacLeod M, Papi A, Contoli M. Chronic obstructive pulmonary disease exacerbation fundamentals: diagnosis, treatment, prevention and disease impact. Respirology. 2021;26(6):532–41. Available from: https://doi.org/10.1111/resp.14041
Reis NF, Oliveira DM, Ferreira LG, Corrêa L, Silva MVR, Oliveira VR. Ventilação não invasiva na unidade de terapia intensiva de um hospital universitário: características relacionadas ao sucesso e insucesso. Fisioter Pesqui. 2019;26(1):3–8. Available from: https://doi.org/10.1590/1809-2950/17000626012019
Scaramuzzo G, Ottaviani I, Volta CA, Spadaro S. Mechanical ventilation and COPD: from pathophysiology to ventilatory management. Minerva Med. 2022;113:460–70. Available from: https://doi.org/10.23736/S0026-4806.22.07974-5
Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: 2017 report. Am J Respir Crit Care Med. 2017;195(5):557–82. Available from: https://pubmed.ncbi.nlm.nih.gov/28182564/
Wedzicha JA, Miravitlles M, Hurst JR, Calverley PMA, Albert RK, Anzueto A, et al. Prevention of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline. Eur Respir J. 2017;50(3). Available from: https://pubmed.ncbi.nlm.nih.gov/28889106/
Xiang G, Zhang X, Liu Y, Wu B. Non-invasive ventilation intervention during exercise training in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ann Phys Rehabil Med. 2021;64(6):101560. Available from: https://pubmed.ncbi.nlm.nih.gov/33271344/
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