Extract
Noninvasive ventilation (NIV) is now an established evidence-based treatment for acute hypercapnic respiratory failure (AHRF), predominantly for defined patients admitted with exacerbations of chronic obstructive pulmonary disease (COPD), but also a range of other conditions including obesity-related respiratory failure and chest wall deformities requiring an acute hospital admission. Over the past two decades, there has been a significant shift towards greater use of NIV in place of invasive mechanical ventilation (IMV) in this group of patients. Here we set out to discuss a landmark paper in this respect: the report of the YONIV trial (Yorkshire Noninvasive Ventilation Trial), published in June 2000, which addressed the key practical questions around the early use of ward-based NIV at the time [1]. A recent narrative review on the epidemiology of NIV for acute respiratory failure in COPD patients concluded that this dramatic increase in NIV use is probably due to the increased experience of the medical teams, treating sicker patients with comorbidities and utilising NIV outside the intensive care unit (ICU), further confirming the pivotal role of the original trial enabling the early use of acute NIV on medical wards [2].
Abstract
The landmark YONIV trial addressed key practical questions surrounding the early use of ward-based noninvasive ventilation, which is now an established evidence-based treatment for acute hypercapnic respiratory failure http://ow.ly/BDC530iWhne
Footnotes
Conflict of interest: R. Mukherjee reports non-financial support from ResMed (training for physiologists and physiotherapists in the NIV unit that he leads), grants from the National Institute for Health Research (NIHR), UK (as a co-investigator in a NIHR-funded systematic review of cost-effectiveness and clinical effectiveness of NIV in stable COPD), and grants from the HOT-HMV trial (Birmingham site principal investigator of the HOT-HMV in COPD trial), all outside the submitted work.
Conflict of interest: R. Nenna has nothing to disclose.
Conflict of interest: A. Turner reports personal fees from ResMed (for chairing a meeting on NIV in COPD), and grants from the National Institute for Health Research (NIHR), UK (as the principal investigator in a NIHR-funded systematic review of cost-effectiveness and clinical effectiveness of NIV in stable COPD), all outside the submitted work.
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