REVIEW  CHRONIC OBSTRUCTIVE PULMONARY DISEASE Free access

Minerva Medica 2022 June;113(3):460-70

DOI: 10.23736/S0026-4806.22.07974-5

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Mechanical ventilation and COPD: from pathophysiology to ventilatory management

Gaetano SCARAMUZZO, Irene OTTAVIANI, Carlo A. VOLTA ✉, Savino SPADARO

Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy

In the chronic obstructive pulmonary disease (COPD), lung and chest-wall morphological alterations determine important and peculiar approaches to mechanical ventilation. Lung emphysema and reduced elastic recoil increase expiratory time, thus worsening dynamic hyperinflation, while airways chronic inflammation rises resistances and can determine distal air-trapping. Muscle wasting and fast fibers prevalence can result in weakness and in an earlier onset of muscle fatigue, prolonging the weaning process. In this narrative review, we explored the connection between altered pathophysiology and necessity for respiratory assistance in COPD, focusing on non-invasive and invasive respiratory management, lung monitoring and weaning difficulties.

KEY WORDS: Pulmonary disease, chronic obstructive; Respiration, artificial; Positive-pressure respiration, intrinsic