Noninvasive Mechanical Ventilation in the Treatment of Community-Acquired Pneumonia

Angel      Ortega-Gonzalez; Maria      Jesus Cobos-Ceballos; Jose      Carlos Serrano-Rebollo; Teresa      Vargas-Hidalgo; Maximo      Gomez-Fernandez; Jose      Javier Garcia-Lopez; Jose      Celdran-Gil

Abstract

Noninvasive mechanical ventilation (NIV) is an effective treatment in acute hypercapnic respiratory failure associated with exacerbated chronic obstructive pulmonary disease and obesity hypoventilation syndrome, among other respiratory diseases. There is less scientific evidence on its application in situations of acute hypoxemic respiratory failure other than acute lung edema. There have been few randomized controlled trials on its efficacy versus standard oxygen therapy or conventional mechanical ventilation in the treatment of severe community-acquired pneumonia, and the results have been contradictory. Its application in selected immunosuppressed patients and patients with acute hypoxemic respiratory failure or chronic obstructive pulmonary disease-associated community-acquired pneumonia may reduce the orotracheal intubation rate, hospital stay, and mechanical ventilation-associated morbidity and mortality. A therapeutic trial with NIV may be appropriate in these situations, but only when the treatment can be continuously monitored and is controlled by specifically-trained professionals.

Keywords: Noninvasive ventilation, pneumonia, randomized controlled trials, acute hypoxemic respiratory failure, acute hypercapnic respiratory failure, COPD

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