Authors: Nicoleta Ștefania Motoc1, 2, Teodora Alexescu3, Carmen Monica Pop1, 2
1Medical Specialties Department, Pulmonology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
2“Leon Daniello” Clinical Hospital of Pneumophysiology, Cluj-Napoca, Romania
3Medical Specialties Department, Internal Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Chronic obstructive pulmonary disease is a prevalent and debilitating respiratory condition with an important mortality, being ranked as the 4th leading cause of death worldwide. Exacerbations are acute events that appear in the natural history of the disease, contributing to its high mortality and morbidity. With each exacerbation, the patient loses pulmonary function resulting in disease progression and reduced exercise ability. Muscular mass loss is common in these patients and has many causes: lack of exercise due to exertional dyspnea, corticosteroid use and systemic inflammation (more important during exacerbations). The purpose of this review is to analyze the use of conventional pressure control ventilation bilevel positive airway pressure in spontaneous/timed mode versus average volume-assured pressure support ventilation (average volume-assured pressure support and intelligent volume-assured pressure support) in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease exacerbation in the light of current research. Although intelligent or hybrid modes do not seem to be superior to pressure control non-invasive ventilation in exacerbation, there are however some groups (chronic obstructive pulmonary disease – obstructive sleep apnea overlap syndrome, patients with chronic obstructive pulmonary disease and morbid obesity) that could benefit. As most data are on chronic respiratory failure, more clinical trials are required in this direction.
Key words: acute exacerbation of chronic obstructive pulmonary disease, pressure assured control modes, average volume-assured pressure support, intelligent volume-assured pressure support.11-motoc139-141