Ten important articles on noninvasive ventilation in critically ill patients and insights for the future

A report of expert opinions

A Cortegiani, V Russotto, M Antonelli, E Azoulay, A Carlucci, G Conti, A Demoule, M Ferrer, N S Hill, S Jaber, P Navalesi, P Pelosi, R Scala, C Gregoretti

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy.

METHODS: We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV.

RESULTS: The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute "de novo" hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony.

CONCLUSIONS: The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still "lack of full evidence" clinical settings.

Original languageEnglish
Pages (from-to)122
JournalBMC Anesthesiology
Volume17
Issue number1
DOIs
Publication statusPublished - Sep 4 2017

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Noninvasive Ventilation
Expert Testimony
Critical Care
Critical Illness
Nose
Respiratory Insufficiency
Chronic Obstructive Pulmonary Disease
Oxygen
Lung Injury
Pulmonary Edema
Mechanical Ventilators
Research
Lung Diseases
Disease Progression
Chronic Disease
Software
Randomized Controlled Trials
Therapeutics

Keywords

  • Journal Article

Cite this

Ten important articles on noninvasive ventilation in critically ill patients and insights for the future : A report of expert opinions. / Cortegiani, A; Russotto, V; Antonelli, M; Azoulay, E; Carlucci, A; Conti, G; Demoule, A; Ferrer, M; Hill, N S; Jaber, S; Navalesi, P; Pelosi, P; Scala, R; Gregoretti, C.

In: BMC Anesthesiology, Vol. 17, No. 1, 04.09.2017, p. 122.

Research output: Contribution to journalArticle

Cortegiani, A, Russotto, V, Antonelli, M, Azoulay, E, Carlucci, A, Conti, G, Demoule, A, Ferrer, M, Hill, NS, Jaber, S, Navalesi, P, Pelosi, P, Scala, R & Gregoretti, C 2017, 'Ten important articles on noninvasive ventilation in critically ill patients and insights for the future: A report of expert opinions', BMC Anesthesiology, vol. 17, no. 1, pp. 122. https://doi.org/10.1186/s12871-017-0409-0
Cortegiani, A ; Russotto, V ; Antonelli, M ; Azoulay, E ; Carlucci, A ; Conti, G ; Demoule, A ; Ferrer, M ; Hill, N S ; Jaber, S ; Navalesi, P ; Pelosi, P ; Scala, R ; Gregoretti, C. / Ten important articles on noninvasive ventilation in critically ill patients and insights for the future : A report of expert opinions. In: BMC Anesthesiology. 2017 ; Vol. 17, No. 1. pp. 122.
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AU - Carlucci, A

AU - Conti, G

AU - Demoule, A

AU - Ferrer, M

AU - Hill, N S

AU - Jaber, S

AU - Navalesi, P

AU - Pelosi, P

AU - Scala, R

AU - Gregoretti, C

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N2 - BACKGROUND: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy.METHODS: We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV.RESULTS: The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute "de novo" hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony.CONCLUSIONS: The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still "lack of full evidence" clinical settings.

AB - BACKGROUND: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy.METHODS: We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV.RESULTS: The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute "de novo" hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony.CONCLUSIONS: The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still "lack of full evidence" clinical settings.

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