Noninvasive respiratory support in the emergency department: Controversies and state‐of‐the‐art recommendations

Abstract Acute respiratory failure is a common reason for emergency department visits and hospital admissions. Diverse underlying physiologic abnormalities lead to unique aspects about the most common causes of acute respiratory failure: acute decompensated heart failure, acute exacerbation of chron...

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Bibliographic Details
Main Authors: Jarrod M. Mosier, Mark Tidswell, Henry E. Wang
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Journal of the American College of Emergency Physicians Open
Online Access:https://doi.org/10.1002/emp2.13118
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Summary:Abstract Acute respiratory failure is a common reason for emergency department visits and hospital admissions. Diverse underlying physiologic abnormalities lead to unique aspects about the most common causes of acute respiratory failure: acute decompensated heart failure, acute exacerbation of chronic obstructive pulmonary disease, and acute de novo hypoxemic respiratory failure. Noninvasive respiratory support strategies are increasingly used methods to support work of breathing and improve gas exchange abnormalities to improve outcomes relative to conventional oxygen therapy or invasive mechanical ventilation. Noninvasive respiratory support includes noninvasive positive pressure ventilation and nasal high flow, each with unique physiologic mechanisms. This paper will review the physiology of respiratory failure and noninvasive respiratory support modalities and offer data and guideline‐driven recommendations in the context of key clinical controversies.
ISSN:2688-1152