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1 无创通气的优点及适应证无创机械通气(NIPPV,本文指无创正压通气)在 COPD 呼吸衰竭的治疗中已经取得很多成功的经验。无创通气的最大优点是不建立人工气道,从而降低了插管的并发症,降低了 VAP 的发生率,缩短了上机时间,降低了医疗费用。有创通气中的通气模式均可用于无创通气,其中 BiPAP 是最常用的模式,相当于有创中的 PSV+PEEP。目前多以专用的无创呼吸机行 NIPPV。无创呼吸机采用涡轮供气的方式,采用口/鼻面罩与患者连接,故不能耐受口/鼻面罩及有影响使用口/鼻面罩的鼻面部外伤或面部畸形者不可使用 NIPPV。漏气补偿能力强。NIPPV 使用指征的把握:由于呼吸肌疲劳和痰液引流不畅是 COPD 呼吸衰竭的两个主要原因,COPD 急性加重期由于气
Noninvasive Ventilation Advantages and Indications Noninvasive mechanical ventilation (NIPPV, herein referred to as noninvasive positive pressure ventilation) has gained a great deal of successful experience in the treatment of COPD respiratory failure. The biggest advantage of non-invasive ventilation is not to establish artificial airway, thus reducing the complications of intubation, reducing the incidence of VAP, shorten the machine on time and reduce medical costs. Invasive ventilation mode ventilation can be used for noninvasive ventilation, BiPAP is the most commonly used mode, which is equivalent to invasive PSV + PEEP. Currently more dedicated non-invasive ventilator line NIPPV. Noninvasive ventilators are supplied by a turbine and connected to the patient using a mouth / nose mask. NIPPV can not be used with mouth / nose masks and nasal facial injuries or facial deformities that affect the use of mouth / nose masks. Leakage compensation ability. NIPPV use of the indications: As respiratory muscle fatigue and poor drainage of sputum is the two main causes of COPD respiratory failure, acute exacerbation of COPD due to gas