These guidelines conditionally support the application of LTH-NIV to improve health outcome by targeting a reduction in carbon dioxide in COPD patients with persistent hypercapnic respiratory failure.
Recommends (1) serum bicarbonate level <27 mmol/L is used to exclude the diagnosis of OHS in obese patients with sleep-disordered breathing when suspicion for OHS is not very high (<20%) but to measure ABG in patients strongly suspected of having OHS, (2) stable ambulatory patients with OHS receive positive airway pressure (PAP), (3) CPAP rather than NIV be offered as the first-line treatment to stable ambulatory patients with OHS and coexistent severe OSA (4) patients hospitalized with respiratory failure and suspected of having OHS be discharged with NIV until they undergo outpatient diagnostic procedures and PAP titration in the sleep laboratory (ideally within 2–3 mo), (5) patients with OHS use weight-loss interventions that produce sustained weight loss of 25% to 30% of body weight to achieve resolution of OHS (which is more likely to be obtained with bariatric surgery).
Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. Specific conditions where recommendations were made include exacerbation of chronic obstructive pulmonary disease, cardiogenic pulmonary oedema, de novo hypoxaemic respiratory failure, immunocompromised patients, chest trauma, palliation, post-operative care, weaning and post-extubation.
The aim of this guideline from the British Thoracic society and Intensive Care Society is to draw attention to suboptimal care in AHRF in the UK, provide an overview of the evidence supporting the use of invasive and non-invasive ventilation, encourage better communication between admitting clinicians and critical care services, promote the use of AHRF patient pathways, and improve resourcing, training, outcomes and patient experience for all adults who develop AHRF.
Agency for Clinical Innovation Respiratory Network consensus statement recommended by the Thoracic Society of Australia and New zealand and the Australasian Sleep Association. The recommendations are designed to standardise criteria for how to assess / screen for the need to commence NIV, provide indications for NIV which reflect the best evidence from the literature and expert opinion, identify best practice recommendations for implementing NIV and ancillary care measures and describe best practice management for initial review and ongoing follow up of patients once commenced on NIV
Clinical guideline from the British Thoracic Society on the Respiratory Management of Children with Neuromuscular Weakness
This clinical guideline from the National Institute for Health and Clinical Excellence (NICE) considers the signs and symptoms that can predict respiratory impairment in patients with MND, the investigations for detecting and monitoring respiratory impairment, and the clinical and cost effectiveness of non-invasive ventilation.
Noninvasive Positive Pressure Ventilation (NPPV) Titration Task Force of the American Academy of Sleep Medicine clinical practice guideline for the adjustment of Noninvasive Positive Pressure Ventilation (NPPV) in Stable Chronic Alveolar Hypoventilation Syndromes
An Official American Thoracic Society Clinical Policy Statement: Congenital Central Hypoventilation Syndrome. Genetic Basis, Diagnosis, and Management
The Use of Non-Invasive Ventilation in the management of patients with chronic obstructive pulmonary disease admitted to hospital with acute type II respiratory failure (with particular reference to Bilevel positive pressure ventilation) produced by the Royal College of Physicians, British Thoracic Society and Intensive Care Society
The Thoracic Society of Australia and New Zealand Consensus Statement from the Australasian Paediatric Respiratory Group on Ventilatory Support at Home for Children.
European Respiratory Society (ERS), the American Thoracic Society (ATS), the European Society of Intensive Care Medicine (ESICM), the Society of Critical Care Medicine (SCCM) and the Socie´te´ de Re´animation de Langue Francaise (SRLF) Statement of the Sixth International Consensus Conference on Intensive Care Medicine on weaning from mechanical ventilation