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
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
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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Рецензия
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. PULMONOLOGIYA. 2017;27(2):232-249. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-2-232-249
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