When administered as first-line intervention to patients admitted with acute hypercapnic respiratory failure secondary to COPD exacerbation in conjunction with guideline-recommended therapies, noninvasive ventilation (NIV) has been shown to reduce mortality and endotracheal intubation. Opportunities to increase uptake of NIV continue to exist despite inclusion of this therapy in clinical guidelines. Identifying patients appropriate for NIV, and subsequently providing close monitoring to determine an improvement in clinical condition involves a team consisting of physician, nurse, and respiratory therapist in institutions that successfully implement NIV. We describe to our knowledge the first known evidence-based algorithm speaking to initiation, titration, monitoring, and weaning of NIV in treatment of acute exacerbation of COPD that incorporates the necessary interprofessional collaboration among physicians, nurses, and respiratory therapists caring for these patients.

中文翻译：

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利用循证跨专业临床实践应用无创通气治疗慢性阻塞性肺病急性加重

当对因 COPD 恶化继发的急性高碳酸血症呼吸衰竭入院的患者进行一线干预并结合指南推荐的治疗时，无创通气 (NIV) 已被证明可以降低死亡率和气管插管。尽管该疗法已纳入临床指南，但增加 NIV 吸收的机会仍然存在。确定适合 NIV 的患者，并随后提供密切监测以确定临床状况的改善，需要一个由成功实施 NIV 的机构中的医生、护士和呼吸治疗师组成的团队。据我们所知，我们描述了第一个已知的基于证据的算法，涉及 NIV 在 COPD 急性加重治疗中的启动、滴定、监测和撤机，其中结合了照顾这些患者的医生、护士和呼吸治疗师之间必要的跨专业合作。