A plethora of researches have been conducted with an objective of investigating the utilization of NIV in treatment of exacerbations of COPD, which have gone to extremity or have reached an acute stage…
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The main objective of this paper is to review what has been found by various studies on the survival challenges, quality of life and the compliance to NIV therapy by the users. Also, the paper will review literature on the effectiveness of the NIV treatment. Challenges on survival, Quality of life and compliance to NIV therapy According to the studies by Massimo, et al (2012, pp747), it was gathered that there are indications of early NIV positive pressure ventilation, which tend to increase the rate of survival. This was made in comparison with NIPPV. As such, NIV acts as a relief from challenges relating to survival rate in patients with high level of CO2 in their blood. A study by Pepin, et al (2008, pp360) indicates these challenges. According to the study, the challenges that these patients face are: fatigue, sleep patterns that are disturbed as well as breathlessness. The group also found out that NIV does not provide a prevention against weakening of the respiratory muscle that tend to progress. Acute exacerbations of a chronic Obstructive Pulmonary Disease better referred to as COPD, pose great challenge to the survival rate of a patient. In the periods that the patient is faced with worsening extremes, it adversely affects the patient’s health status. There is an escalating admission to hospitals and even rise of mortality rates (Angus, et al 2011, pp84). According to the studies by Fionnuala, et al (2007, pp60), it is approximated that the mortality rate of in-patient ranged from 4%-30%. The study goes on to indicate that patients that are admitted due to complications from acute Respiratory failure have a higher mortality rate. According to the study, the patients who are elderly and have co morbidities as well as those patients needing the ICU facilities were the most affected by the high mortality rate. According to the study by Monica, et al (2004, pp605), ventilation of the respiratory worsens to perfusion ratio and this result to a mechanism in the hypoxemia occurrence. This happens when psychological dead space enlarges. It also occurs when there is a rise in the ventilation waste. In the study by Suzy (2012, pp61), it was identified that increased resistance of the airway as well as the need for high minute ventilation tend to result to a limitation on the expiratory flow. Still, the study found out that a dynamic hyperinflation, enlarged threshold of the aspiratory load as well as respiratory muscle dysfunction result to a feeling of fatigue in a patient. Plant and Elliott (2003) studied that a rapid pattern of breathing, which is somehow shallow, occurs. This is due to the respiratory system efforts towards maintenance of enough ventilation in the alveoli. This happens when the elastic, resistive and loads of aspiratory threshold are introduced to the weakened muscles of the respiratory system. However, irrespective of an increment in stimulus of the centers of the respiratory system as well as swings in the large, negative intra-thoracic pressure, carbon dioxide is still retained and as such, acedemia occurs. Other studies by Rossi, et al (1995) and Ambrosino, et al (1997) established that severe COPD which is complicated by ARF, attain characteristics such as; right ventricular failure, encephalopathy as well as dyspnea and these pose as serious challenges to the survival of the patient. In regards to the studies by Eliott (2012, pp85), a vital intervening is advantageous to the patient with COPD is advisable. He suggested a clinical experience and this was an NIV treatment. Does NIV improve respiratory function or increase survival? A
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