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Noninvasive ventilation as ceiling of therapy in end-stage chronic obstructive pulmonary disease

Creagh-Brown, B.C. and Shee, C.D. (2008) Noninvasive ventilation as ceiling of therapy in end-stage chronic obstructive pulmonary disease Chronic Respiratory Disease, 5 (3). pp. 143-148.

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Abstract

The benefits of noninvasive ventilation (NIV) for acute hypercapnic respiratory failure caused by chronic obstructive pulmonary disease (COPD) are well recognized and consequently its use is widespread. Prognostication in advanced COPD is imperfect, limiting accurate identification of 'end-stage' COPD. Decisions regarding withholding invasive ventilation are largely dependent upon prognostication. In patients where 'invasive' ventilation is not considered to be in their best interests, NIV will be the ceiling of therapy. In this patient group, NIV is extremely valuable in reducing mortality and providing valuable symptomatic benefit. We discuss the use of NIV in the management of an acute exacerbation of 'end-stage' COPD where NIV is the ceiling of therapy, the use of advanced directives and the implications of the Mental Capacity Act 2005 on decisions regarding end-of-life care. We highlight areas where further research would be useful. © SAGE Publications 2008.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Creagh-Brown, B.C.b.creagh-brown@surrey.ac.uk
Shee, C.D.
Date : 1 August 2008
DOI : 10.1177/1479972308089234
Uncontrolled Keywords : Ceiling of treatment; COPD; Dyspnea; NIV; Palliative care; Respiratory failure
Depositing User : Clive Harris
Date Deposited : 22 Mar 2019 08:16
Last Modified : 22 Mar 2019 08:16
URI: http://epubs.surrey.ac.uk/id/eprint/850777

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