How to ventilate obstructive and asthmatic patients

Alexandre Demoule, Laurent Brochard, Martin Dres, Leo Heunks, Amal Jubran, Franco Laghi, Armand Mekontso-Dessap, Stefano Nava, Lamia Ouanes-Besbes, Oscar Peñuelas, Lise Piquilloud, Theodoros Vassilakopoulos, Jordi Mancebo
Intensive Care Medicine 2020 November 9
Exacerbations are part of the natural history of chronic obstructive pulmonary disease and asthma. Severe exacerbations can cause acute respiratory failure, which may ultimately require mechanical ventilation. This review summarizes practical ventilator strategies for the management of patients with obstructive airway disease. Such strategies include non-invasive mechanical ventilation to prevent intubation, invasive mechanical ventilation, from the time of intubation to weaning, and strategies intended to prevent post-extubation acute respiratory failure. The role of tracheostomy, the long-term prognosis, and potential future adjunctive strategies are also discussed. Finally, the physiological background that underlies these strategies is detailed.

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