Revue des maladies respiratoires
-
Non invasive mechanical ventilation represents all the techniques of mechanical ventilation not using endotracheal connection to the respirator. Non invasive mechanical ventilation is essentially represented nowadays by facial (generally used for acute respiratory failure) and nasal ventilation (widely used for long term mechanical ventilation at home). ⋯ In parallel, more recent studies have demonstrated the interest of that technique in immediate ventilatory link in the spectrum of weaning of endotracheal mechanical ventilation. In hypoxic acute respiratory failure, non invasive mechanical ventilation remains controversial and seems to be better indicated in moderate to severe respiratory status.
-
Self-adjusted Continuous Positive Airway Pressure or autoCPAP machines have been engineered to automatically adjust the pressure to maintain the upper airway patency. They can be used for titration or long-term home therapy. They have been developed to improve efficiency and compliance of CPAP treatment and the cost-effectiveness of titration and also to decrease the long waiting lists for manual titration. ⋯ In general, optimal CPAP determined automatically are identical or lower than evaluated manually by experienced technicians. However, the long-term benefits of auto-CPAP on compliance have not been determined and require further controlled clinical studies taking account not only compliance, but also sleep quality, quality of life, alertness and cognition for each autoCPAP. The cost-effectiveness of auto-titration versus conventional titration remains also to be established.