New modes in non-invasive ventilation
Résumé
Non-invasive ventilation is useful to treat some forms of respiratory failure. Hence, the number of patients receiving this treatment is steadily increasing. Considerable conceptual and technical progress has been made in recent years by manufacturers concerning this technique. This includes new features committed to improve its effectiveness as well as patient-ventilator interactions. The goal of this review is to deal with latest advances in ventilatory modes and features available for non-invasive ventilation. We present a comprehensive analysis of new modes of ventilator assistance committed to treat respiratory failure (hybrid modes) and central and complex sleep apnea (adaptive servo ventilation), and of new modes of triggering and cycling (neurally adjusted ventilatory assist). Technical aspects, modes of operation and settings of these new features as well as an exhaustive review of published data, their benefits and limits, and the potential place of these devices in clinical practice, are discussed. (C) 2015 Elsevier Ltd. All rights reserved.
Mots clés
Ventilatory modes
Central sleep apnea
Non invasive ventilation
Neuro adjusted ventilatory assist
Respiratory failure
Adaptative servo ventilation
Chronic heart-failure
Complex sleep-apnea
Cheyne-stokes respiration
Assured pressure support
Positive airway pressure
Randomized controlled-trial
Obstructive pulmonary-disease
Diaphragm electrical-activity
Improves cardiac-function
Review