pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLCpulmo-3473Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESИспользование неинвазивной вентиляции легких с двумя уровнями положительного давления у больных с острой дыхательной недостаточностьюNon-invasive bi-level positive airway pressure ventilation (BIPAP) in the treatment of acute respiratory failureАвдеевС. Н.AvdeevS. N.

Москва

ТретьяковА. В.TretjakovA. V.

Москва

НИИ пульмонологии М3 РФRussian Federation199630121996043337Copyright © Авдеев С.Н., Третьяков А.В., 19961996Авдеев С.Н., Третьяков А.В.Avdeev S.N., Tretjakov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/3473

Искусственная вентиляция легких традиционно является эффективным средством респираторной поддержки у больных с острой дыхательной недостаточностью (ОДН), но требует применения «инвазивных процедур» – интубации трахеи или трахсостомии, которые могут приводить к развитию серьезных осложнений – «вентиляционным» пневмониям, механическим повреждениям гортани и трахеи и др. В настоящей статье обсуждается применение нового альтернативного метода вентиляции – масочной неинвазивной вентиляции легких (мНВЛ) с использованием режима с двумя уровнями положительного давления. Рассматриваются показания к назначению мНВЛ, критерии исключения, режимы вентиляции у группы пациентов, у которых мНВЛ может иметь успех. Приводятся результаты некоторых контролируемых и неконтролируемых исследований, демонстрирующих снижение летальности, потребности в интубации трахеи, длительности пребывания в стационаре при терапии мНВЛ. Представлен клинический случай больного с ОДЫ на фоне обострения хронического обструктивного бронхита, у которого был достигнут хороший клинический эффект при использовании мНВЛ.

Mechanical intermittent positive pressure ventilation effectively provides ventilatory support in patients with acute respiratory failure (ARF), but it requires placing artificial airways resulting in such complications as ventilator pneumonia, mechanical damage of larynx and trachea and others. In this article we discuss the validities and advantages of alternative method of mechanical ventilation – non-invasive positive pressure ventilation (NPPV) via nasai and facial masks. We consider indication and exclusion cruteria for NPPV, different modes of ventilation used more often with NPPV, the groups of patients with ARF which may benefit from NPPV. We also review several controlled and uncontrolled stydies showed advantages of NPPV over convectional methods resuited in reduction in intubation rates, hospital mortality and length of stay in hospital. We present case report showed the efficacy of NPPV in 68-old patient with acute respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease.

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The authors declare that there are no conflicts of interest present.