8(th) International conference on management and rehabilitation of chronic respiratory failure: the long summaries – Part 3

Ambrosino, Nicolino; Casaburi, Richard; Chetta, Alfredo; Clini, Enrico; Donner, Claudio F.; Dreher, Michael; Goldstein, Roger; Jubran, Amal; Nici, Linda; Owen, Caroline A.; Rochester, Carolyn; Tobin, Martin J.; Vagheggini, Guido; Vitacca, Michele; ZuWallack, Richard

Most end-stage patients with chronic respiratory failure complain of dyspnoea in the last 3 months of life [35] . Breathlessness is often more severe in these patients than in those with advanced lung cancer [36] . As a consequence, NIV is being increasingly used to relieve dyspnea in these patients [37, 38] . Recent guidelines state the following: "As relief of dyspnoea with NIV may not relate to changes in arterial blood gases, it is appropriate to reassess the br0eathlessness experienced by patients receiving such ventilatory support at frequent intervals" [39] . Observational studies as well as clinical trials have recently confirmed the role of NIV in patients with chronic disease and poor life expectancy (with or without COPD), showing that this ventilatory technique may favourably reduce dyspnoea shortly after initiation, even without an associated episode of hypercapnic ARF [40] . About half of the patients survived the episode of respiratory distress and were discharged from the hospital.