Неинвазивная вентиляция легких у пациентов с хронической обструктивной болезнью легких в стационаре и домашних условиях


https://doi.org/10.18093/0869-0189-2017-27-2-232-249

Полный текст:


Аннотация

Существенное улучшение ведения пациентов с хронической обструктивной болезнью легких (ХОБЛ) как при обострении, так и в стабильный период обусловлено широким применением в течение 2 последних десятилетий неинвазивной вентиляции легких (НВЛ). В настоящее время НВЛ рассматривается как терапия первой линии у пациентов с обострением ХОБЛ при развитии гиперкапнической острой дыхательной недостаточности. Данный метод респираторной поддержки также оказался эффективным у больных после экстубации: при его использовании не только облегчается процесс отлучения от респиратора, но и установлено положительное влияние при профилактике и лечении постэкстубационной дыхательной недостаточности. НВЛ также успешно применяется при сочетаниях ХОБЛ и синдрома апноэ сна, ХОБЛ и пневмонии, а также в раннем послеоперационном периоде после вмешательств в области грудной клетки. НВЛ также может использоваться у пациентов с ХОБЛ при хронической дыхательной недостаточности. Наиболее обоснованными показаниями для назначения длительной НВЛ в домашних условиях при ХОБЛ является гиперкапния в дневное время. По-видимому, наиболее эффективной стратегией респираторной поддержки при ХОБЛ является снижение парциального давления углекислого газа в артериальной крови – т. н. высокоинтенсивная НВЛ. Применение недавно разработанных переносных портативных аппаратов НВЛ позволяет значительно повысить физическую активность пациентов с ХОБЛ тяжелого течения

Об авторе

С. Н. Авдеев
Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства России»
Россия

Авдеев Сергей Николаевич – доктор медицинских наук, член-корр. Российской академии наук, профессор, руководитель клинического отдела 

105077, Россия, Москва, ул. 11-я Парковая, 32, корп. 4



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Для цитирования: Авдеев С.Н. Неинвазивная вентиляция легких у пациентов с хронической обструктивной болезнью легких в стационаре и домашних условиях.  Пульмонология. 2017;27(2):232-249. https://doi.org/10.18093/0869-0189-2017-27-2-232-249

For citation: Avdeev S.N. Non invasive ventilation in patients with chronic obstructive pulmonary disease in a hospital and at home. Russian Pulmonology. 2017;27(2):232-249. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-2-232-249

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)