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Current Geriatrics Reports
Published in: Current Geriatrics Reports 3/2019

01-09-2019 | COPD Exacerbation | Surgical Care (F Luchette and R Gonzalez, Section Editors)

Non-invasive Ventilatory Support in the Elderly

Authors: Kasiemobi E. Pulliam, Timothy A. Pritts

Published in: Current Geriatrics Reports | Issue 3/2019

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Abstract

Purpose of Review

The first description of non-invasive ventilation use began in the 1920s. Since then, its role in patient care has evolved through increased clinical knowledge and scientific advancements. The utilization of non-invasive ventilation has broadened from initial application in acute in-hospital ICU settings to now include the outpatient settings. This review discusses the history of non-invasive ventilation and its role in acute in-hospital chronic obstructive pulmonary disease (COPD) exacerbations, cardiogenic pulmonary edema, and weaning from mechanical ventilation in the elderly. The elderly population represents a significant portion of patients hospitalized for the aforementioned conditions. These groups often have more limitations related to the use of invasive mechanical ventilation (IMV); therefore, it is essential to understand the impact of non-invasive ventilation on hospital outcomes.

Recent Findings

There is strong clinical evidence supporting the use of non-invasive ventilation in patients with respiratory failure secondary to acute COPD exacerbations and cardiogenic pulmonary edema. When compared to standard medical management of these conditions, there is a consistent and significant reduction in the rate of endotracheal intubation and in-hospital mortality.

Summary

The basis of non-invasive ventilation applicability has been determined by significant reduction in mortality and intubation rates. Although survival benefits have been observed, there still remain limitations to the clinical applicability of non-invasive ventilation in certain patient populations and conditions that require further investigation.
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Metadata
Title
Non-invasive Ventilatory Support in the Elderly
Authors
Kasiemobi E. Pulliam
Timothy A. Pritts
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Geriatrics Reports / Issue 3/2019
Electronic ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-019-00287-5

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