Non-Invasive Ventilation and Palliative Care: An Overview
Author(s): Nicolini Antonello
An ageing population and steady increase in the rates of neoplasms and chronic degenerative diseases pose a challenge for societies and their healthcare systems. Because of the recent and continuous advances in therapies, such as the development and widespread use of non-invasive ventilation (NIV), survival rates have increased for these pathologies. For patients with end-stage chronic respiratory diseases, the use of NIV following the onset of acute or severe chronic respiratory failure is a valid option when intubation has been excluded. The available evidence strongly supports the use of NIV in patients presenting with an exacerbation of COPD, as well as with end-stage neuromuscular disease. Few studies support the use of NIV in end-stage interstitial lung disease. For patients with cancer palliative NIV has been recommended to improve dyspnea. The decision regarding the treatment should be made by the patient, ideally before reaching the terminal stage and after having a frank dialogue with healthcare professionals and family members.