Revue des maladies respiratoires
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Lung transplantation (LT) is accepted as a therapeutic option in a wide range of end stage lung diseases, with evidence supporting survival and quality of life benefits in transplant recipients. Appropriate patients who have good chance of survival with transplantation should be identified carefully. ⋯ Careful selection of potential candidates for lung transplantation at the most appropriate time should lead to an improvement of survival of such patients.
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The occurrence of life threatening severe respiratory failure in patients with an incurable illness may be an indication for the use of noninvasive ventilation (NIV). ⋯ NIV may palliate symptoms in patients near the end of life. In the case of severe ARF in patients with do-not-intubate orders, NIV may avoid the need for endotracheal mechanical ventilation, most often in patients with COPD or cardiogenic pulmonary oedema. NIV may help some patients to forego endotracheal intubation. Future studies are needed to examine the attitudes of patients and families to this intervention.