Scholarlink

Noninvasive ventilation (NIV) stands as a cornerstone in heart failure management’s therapeutic landscape, encompassing its acute and chronic forms. In the acute setting, nearly half of all patients diagnosed with acute heart failure (AHF) present with severe respiratory failure. This clinical manifestation, primarily characterized by hypoxemia and, in some cases, accompanied by hypercapnia, is a leading cause of hospital admissions for these patients. The utility of NIV in this context is multifaceted, significantly alleviating the increased work of breathing experienced by these patients. It causes improved left ventricular function by decreasing its preload and afterload. Caution is required in patients with isolated right heart failure, as they can experience a fall in cardiac output due to decreased venous return to the right heart. The benefits of NIV extend beyond the acute phase of heart failure, offering substantial therapeutic value in the management of chronic heart failure (CHF) as well. Patients with CHF frequently suffer from sleep-disordered breathing conditions, including obstructive sleep apnea (OSA) and central sleep apnea (CSA). These disorders exacerbate the underlying heart condition by imposing additional strain on the cardiovascular system. OSA, characterized by repetitive episodes of airway obstruction during sleep, leads to significant nocturnal oxygen desaturation and increased sympathetic activity, both of which can worsen heart failure. Similarly, CSA, marked by a reduction or cessation of airflow resulting from decreased respiratory drive, contributes to the cycle of worsening cardiac function. NIV emerges as a critical intervention in this scenario, mitigating the adverse effects of sleep-disordered breathing on the heart. By ensuring a stable airway and improving oxygenation during sleep, NIV can substantially reduce the burden of OSA and CSA on the cardiovascular system. This not only improves the quality of sleep but also has the potential to stabilize and enhance cardiac function over time, thereby improving overall prognosis and quality of life for patients with CHF.

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Evidence-Based Management of Respiratory Failure with Noninvasive Approach in Acute and Chronic Heart Failure

  • 章节

  • 发表日期：

    2025年

查看全文
  • Sanjay Singhal,
  • Armin Ahmed,
  • Mohan Gurjar

摘要

Noninvasive ventilation (NIV) stands as a cornerstone in heart failure management’s therapeutic landscape, encompassing its acute and chronic forms. In the acute setting, nearly half of all patients diagnosed with acute heart failure (AHF) present with severe respiratory failure. This clinical manifestation, primarily characterized by hypoxemia and, in some cases, accompanied by hypercapnia, is a leading cause of hospital admissions for these patients. The utility of NIV in this context is multifaceted, significantly alleviating the increased work of breathing experienced by these patients. It causes improved left ventricular function by decreasing its preload and afterload. Caution is required in patients with isolated right heart failure, as they can experience a fall in cardiac output due to decreased venous return to the right heart. The benefits of NIV extend beyond the acute phase of heart failure, offering substantial therapeutic value in the management of chronic heart failure (CHF) as well. Patients with CHF frequently suffer from sleep-disordered breathing conditions, including obstructive sleep apnea (OSA) and central sleep apnea (CSA). These disorders exacerbate the underlying heart condition by imposing additional strain on the cardiovascular system. OSA, characterized by repetitive episodes of airway obstruction during sleep, leads to significant nocturnal oxygen desaturation and increased sympathetic activity, both of which can worsen heart failure. Similarly, CSA, marked by a reduction or cessation of airflow resulting from decreased respiratory drive, contributes to the cycle of worsening cardiac function. NIV emerges as a critical intervention in this scenario, mitigating the adverse effects of sleep-disordered breathing on the heart. By ensuring a stable airway and improving oxygenation during sleep, NIV can substantially reduce the burden of OSA and CSA on the cardiovascular system. This not only improves the quality of sleep but also has the potential to stabilize and enhance cardiac function over time, thereby improving overall prognosis and quality of life for patients with CHF.