Неинвазивная вентиляция легких и респираторная реабилитация: современное состояние и перспективы развития

Работа посвящена современным технологиям неинвазивной вентиляции легких (НИВЛ) и методам респираторной реабилитации у пациентов с острой дыхательной недостаточностью (ОДН) различного генеза. Систематизированы данные отечественных и зарубежных исследований за последние 10 лет, включающие основные механизмы патогенеза ОДН, возможности и ограничения НИВЛ и сравнительный анализ используемых интерфейсов. Отдельно рассмотрены вопросы дисфункции дыхательной мускулатуры при ОДН, методы ее оценки и возможности восстановления функции внешнего дыхания посредством респираторных тренажеров. В работе обобщены результаты исследований, демонстрирующих потенциал интеграции НИВЛ и респираторных тренажеров в комплексной терапии пациентов с ОДН. Обсуждаются перспективы дальнейшего изучения эффективности и безопасности этих подходов в различных клинических ситуациях.

1. Алексеев Н.П., Морозов А.А. Респираторная реабилитация: современные подходы. Вестн. восстанов. мед.2022. № 1. С. 25–31.

2. Альтшулер В.М., Богданова М.В. Повышенное внутричерепное давление и дыхательные упражнения: мифы и реальность. Журнал неврологии и психиатрии. 2020. № 7. С. 51–56.

3. Астахов А.А., Бодров И.В., Карпов И.А. Современные технологии дыхательной реабилитации: методические подходы и аппаратные средства. Вестник восстановительной медицины. 2023. № 2. С. 35–42.

4. Баринов А.П., Макарова И.В., Сотникова И.А. Применение PEP – терапии при бронхолегочной патологии у детей. Вопросы современной педиатрии. 2022. Т. 21, № 3. С. 167–172.

5. Белов Ю.С., Курлянд Н.Б. и др. Реабилитация при внебольничных пневмониях. Практическая медицина. 2020. № 10. С. 100–107.

6. Беляев А.С., Короткова Н.Э., и др. Влияние шлем – NIV на архитектуру сна. Росс. пульмонол. журнал. 2023. № 5. С. 28–35.

7. Бойцов С.А., Алексеев А.М. Инновационные технологии дыхательной реабилитации: от тренажеров к геймифицированным платформам. Пульмонология. 2022. № 4. С. 17–22.

8. Воробьев А.А., Павлов С.В. Эффективность осциллирующих экспираторных устройств при ХОБЛ. Фарматека. 2021. № 12. С. 55–59.

9. Гайворонский И.В. Топографическая анатомия человека. СПб.: СпецЛит, 2019. 496 с.

10. Гуревич М.А., Селезнев И.В. Применение инцентив – спирометров в послеоперационной реабилитации. Российский журнал физиотерапии, курортологии и восстановительной медицины. 2022. Т. 21, № 4. С. 45–50.

11. Дробязго В.В., Федоров А.А. Тренировка инспираторных мышц у пациентов, находящихся на ИВЛ. Анестезиология и реаниматология. 2019. № 6. С. 44–52.

12. Дыхательная реабилитация: клинические рекомендации. Под ред. Чучалина А.Г. М.: ГЭОТАР Медиа, 2021. 312 с.

13. Дыхательные тренажеры «Волна» и «Дыхательная пружина». СПб.: Спульмо, 2023. 20 с.

14. Дыхательный тренажер POWERbreathe Fitness Classic. Владивосток: ПрофиСпорт ДВ, 2024. 14 с.

15. Иванов И.И., Петров А.С. Дыхательный метаборефлекс и периферическая вазоконстрикция при утомлении инспираторных мышц. Патофизиология. 2015. Т. 22, № 2. С. 34–40.

16. Иванова Н.Ю., Зайцев И.П. Применение дыхательных тренажеров в амбулаторной практике. Здоровье и дыхание. 2020. № 6. С. 21–26.

17. Инструкция по применению дыхательного аппарата «Самоздрав». М.: ООО «Институт Самоздрав», 2020. 24 с.

18. Инструкция по применению устройства PARI PEP® – System II. М.: ООО «ПАРИ Рус», 2021. 12 с.

19. Каштанова Л.А., Воронова Н.Б. Индивидуализация дыхательной реабилитации: современные принципы. Вестник современной клинической медицины. 2021. № 4. С. 69–74.

20. Киселева М.В., Сергеева О.С. Аппараты типа Flutter и Acapella в клинической практике. Пульмоэксперт. 2019. № 2. С. 14–19.

21. Корякин А.Г., Власенко А.В., Евдокимов Е.А., Маковей В.И., Ерофеев В.В., Осипов С.А., Родионов Е. П., Сластников Е.Д., Клюев И.С. Высокопоточная оксигенотерапия при отлучении от респиратора пациентов – канюленосителей. Медицинский алфавит. 2023; (6): 39–49.

22. Крапивин С.В., Новиков Д.Е. Сравнение носовой и лицевой маски при обострении ХОБЛ. Пульмонология. 2019. № 4. С. 42–49.

23. Кузнецов П.В., Орлова Т.В. Влияние положительного давления на гемодинамику. Евразийский архив травматологии. 2021. № 4. С. 55–62.

24. Кулабухов А. В., Стрижков А. В. Нейрогенные расстройства дыхания у критически больных. Анестезиология и реаниматология. 2021. № 6. С. 5–14.

25. Лещенко В.В., Лещенко А.В., Зиновьева Л.Е. Современные подходы к дыхательной реабилитации после COVID‑19. Пульмонология. 2021. № 3. С. 18–29.

26. Макарова И.И., Романов П.В. Медицинская реабилитация при респираторной недостаточности. Пульмонология. 2021. Т. 31, № 2. С. 45–51.

27. Макарова Т.В., Бабина Л.М. и др. Противопоказания к дыхательной реабилитации у пациентов с острыми респираторными нарушениями. Практическая медицина. 2021. № 2. С. 62–69.

28. Мишина Е.В., Ермаков А.А. Неинвазивная вентиляция после экстубации. Анестезиология и реаниматология. 2024. № 2. С. 36–42.

29. Мясникова Е.В., Грачев А.В. Буллезная эмфизема: современные подходы к лечению. Пульмонология. 2022. № 4. С. 78–84.

30. Нерсесян А.А., Горбунова Е.А. Влияние PEEP на газообмен при неинвазивной вентиляции легких. Анестезиология и реаниматология. 2022. № 3. С. 12–18.

31. Петрова С.М., Ульянов Д.В. Реабилитация дыхательной функции у пациентов с постковидным синдромом: роль инспираторных тренажеров с биологической обратной связью. Пульмонология. 2021. № 6. С. 45–51.

32. Практическое руководство по дыхательной терапии и респираторной реабилитации. Под ред. А.В. Ястребова. М.: ГЭОТАР Медиа, 2022. 224 с.

33. Российская ассоциация анестезиологов‑реаниматологов. Консенсус по неинвазивной вентиляции легких. М.: РААР, 2010. 52 с.

34. Российская ассоциация анестезиологов‑реаниматологов. Методические рекомендации по неинвазивной вентиляции легких. М., 2023. 64 с.

35. Рудакова С.В., Королева О.Е. Когнитивные нарушения и респираторная реабилитация. Журнал неврологии и психиатрии. 2023. № 2. С. 42–49.

36. Сайт Spulmo.ru – Обзор респираторных тренажеров: принципы действия и показания.

37. Сапин М. Р., Брыксин З.Г. Анатомия человека: учебник. М.: ГЭОТАР Медиа, 2022. 672 с.

38. Сафронов С. В., Кузнецов В. И. Реабилитация после кардиохирургических вмешательств. Клиническая медицина. 2022. № 5. С. 39–45.

39. Сидоренко Е.Н., Зорина Л.Р. Дисфункция диафрагмы при длительной искусственной вентиляции легких. Вестник интенсивной терапии. 2020. Т. 17, № 4. С. 22–30.

40. Скворцов В.В., Дробышев А.В. Респираторный драйв и коррекция при ОДН. Критическая медицина. 2023. Т. 17, № 2. С. 45–53.

41. Соловьева С.В., Горбунова О.Ю., Коновалова Н.И. Реабилитация пациентов с ХОБЛ: современные методы. Медицинский альманах. 2021. № 2. С. 89–97.

42. Стандарты специализированной медицинской помощи при хронических обструктивных заболеваниях легких. Минздрав РФ, 2021. 58 с.

43. Степанов М.Е., Михайлов А.В. Влияние дыхательной гимнастики на функцию внешнего дыхания при инсульте. Реабилитация. 2020. № 3. С. 44–48.

44. Тетерин А.Н., Тарасов А.И. Комплексная физиотерапия в пульмонологии: учебно‑практическое пособие. СПб.: СпецЛит, 2021. 112 с.

45. Федеральные клинические рекомендации по респираторной реабилитации взрослых. М.: Министерство здравоохранения РФ, 2022. 52 с.

46. Шевелева И.М., Ларина Т.Н. Побудительная спирометрия в реабилитации пациентов после экстубации. Вопросы курортологии, физиотерапии и лечебной физкультуры. 2018. № 5. С. 45–49.

47. Шляхов Е.С., Михайлов А.А. Физиологические эффекты НИВЛ в клинической практике. Бюллетень БГМУ. 2022. Т. 8, № 1. С. 14–22.

48. Шмелева Н.М., Злобина О.В. Профилактика дыхательных осложнений у хирургических больных с использованием инспираторных тренажеров. Вестник восстановительной медицины. 2020. № 2. С. 27–31.

49. Шмидт Н.С., Миронова О.Н. Тренировка дыхательных мышц у пациентов с хронической обструктивной болезнью легких. Пульмонология. 2018. Т. 28, № 2. С. 67–74.

50. Ali A., Abdelrahman H., Hussein A. и др. Helmet versus face mask noninvasive ventilation in hypercapnic acute respiratory failure: a randomized controlled trial. Egyptian Journal of Chest Diseases and Tuberculosis. 2011. Vol. 60, No. 4. P. 321–327. DOI: 10.1016/j.ejcdt.2011.07.002

51. Ambrosino N., Clini E.M. Response to “Pulmonary rehabilitation in COVID‑19 pandemic era”. Eur Respir J. 2020. Vol. 55, No. 6. P. 2001073.

52. American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002; 166 (4): 518–624.

53. Antonaglia V., Verzola G., Braschi A. и др. Sequential use of face mask and helmet for noninvasive ventilation in acute exacerbation of COPD: a prospective crossover study. Respiratory Care. 2011. Vol. 56, No. 12. P. 1825–1831. DOI: 10.4187/respcare.01136

54. Antonelli M., Conti G., Rocco M., et al. Noninvasive ventilation for treatment of acute respiratory failure in immunocompromised patients. N. Engl. J. Med. 1998. Vol. 339, No. 21. P. 164–171.

55. Arabati H., Poursalehi F., Ghorbani F. Non – invasive ventilation in burn patients with inhalation injury: a clinical review. Burns. 2019. Vol. 45, No. 6. P. 1233–1240.

56. Arabi Y.M., Salama M., Al Hameed F. и др. Helmet non‑invasive ventilation versus usual care in acute hypoxemic respiratory failure: a randomized controlled trial. Critical Care. 2023. Vol. 27. Art. 112. DOI: 10.1186/s13054‑023‑04321‑7

57. ATS/ERS Statement on respiratory muscle testing. European Respiratory Journal. 2002. Vol. 19. P. 209–238.

58. Azoulay E., Lemiale V., Mokart D., et al. Effect of Noninvasive Ventilation vs Oxygen Therapy on Mortality Among Immunocompromised Patients with Acute Respiratory Failure: A Randomized Clinical Trial. JAMA. 2015. Vol. 314, No. 16. P. 1711–1719.

59. Bach J.R., Gonçalves M.R. Mouthpiece ventilation in neuromuscular disease. Respir. Care. 2020. Vol. 65. P. 712–720.

60. Bartlett R.H., Brennan M.L., Gazzaniga A.B., Hanson E.L. Studies on the pathogenesis and prevention of postoperative pulmonary complications. Surg Gynecol Obstet. 1973; 137 (6): 925–933.

61. Beaumont M., Mialon P., et al. Inspiratory muscle training during pulmonary rehabilitation in chronic obstructive pulmonary disease: a systematic review and meta – analysis. Chron Respir Dis. 2018. Vol. 15, No. 4. P. 394–404.

62. Bellani G., Patroniti N., Greco G. и др. Helmet CPAP for weaning from prolonged mechanical ventilation: a pilot randomized trial. Critical Care. 2013. Vol. 17, Suppl 2. P. P222. DOI: 10.1186/cc12457

63. Bissett B., Leditschke I.A., Neeman T. et al. Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial. Thorax. 2016; 71(9): 812–819. DOI: 10.1136/thoraxjnl‑2015–208071.

64. Bissett B., Leditschke I.A., Paratz J.D. Inspiratory muscle training to facilitate weaning from mechanical ventilation: protocol for a systematic review. BMJ Open. 2012. Vol. 2, No. 2. P. e000813.

65. Boussuges A., Gole Y., Blanc P. Diaphragmatic motion studied by m‑mode ultrasonography: methods, reproducibility, and normal values. Chest. 2009. Vol. 135, No. 2. P. 391–400. DOI: 10.1378/chest.08–1541.

66. Brill A.– K., Chatwin M., Polkey M.I. Sleep quality under different NIV interfaces. Chest. 2022. Vol. 161. P. 602–611.

67. Brochard L., Isabey D., Piquet J., et al. Continuous positive airway pressure delivered by face mask in acute cardiogenic pulmonary oedema. N. Engl. J. Med. 1995. Vol. 332, No. 4. P. 130–135.

68. Cahalin L.P., Arena R., Guazzi M. et al. Inspiratory muscle training in heart failure and pulmonary disease. Chest. 2013; 143(3): 884–894. DOI: 10.1378/chest.12–1144

69. Çakir O., Demir T., Alptekin S. и др. Comparison of helmet and face mask noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease: randomized controlled trial. Journal of Critical Care. 2015. Vol. 30, No. 6. P. 1193–1198.

70. Carteaux G., Brochard L. Noninvasive ventilation for acute hypoxemic respiratory failure. Intensive Care Med. 2019. Vol. 45, No. 10. P. 1298–1307.

71. Carteaux G., MillánGuitton G., Joyeux M., et al. Assessment of Failure of Noninvasive Ventilation in Hypoxemic Respiratory Failure by the HACOR Score. Intensive Care Med. 2016. Vol. 42, No. 2. P. 199–206.

72. Carteaux G., Millet J., Pouchon A. et al. Bedside adjustment of noninvasive ventilation settings improves breathing pattern and pulmonary gas exchange. Intensive Care Medicine. 2015. Vol. 41, No. 3. P. 376–384.

73. Cesarano M., Grieco D.L., Michi T. идр. Helmet noninvasive support for acute hypoxemic respiratory failure: rationale, mechanism of action and bedside application. Annals of Intensive Care. 2022. Vol. 12, Art. 94. DOI: 10.1186/s13613‑022‑01069‑7

74. Chatburn R.L., Karnatovskaia L.V. Non‑invasive ventilation in children: modes, interfaces and clinical applications. Respiratory Care. 2018. Vol. 63, No. 12. P. 1506–1520.

75. Chaudhuri D., Batt J., Brushey L. и др. Helmet versus facemask for noninvasive ventilation in acute hypercapnic respiratory failure: systematic review and metaanalysis. Critical Care. 2022. Vol. 26, Art. 130. DOI: 10.1186/s13054‑022‑04014‑1

76. Cheah B.C., Boland R.A., et al. Inspiratory muscle training in patients with amyotrophic lateral sclerosis. Eur J Neurol. 2009. Vol. 16, No. 2. P. 170–175.

77. Combes A., Fanelli V., Pham T. Early predictive monitoring during noninvasive ventilation: a multicenter study. Critical Care. 2021. Vol. 25, Art. 162.

78. Combes A., Fanelli V., Pham T. Early predictive monitoring during noninvasive ventilation: a multicenter study. Critical Care. 2021. Vol. 25, Art. 162.

79. Condessa R.L., Brauner J.S., Saul A.L. et al. Inspiratory muscle training did not accelerate weaning from mechanical ventilation but did improve tidal volume and maximal inspiratory pressure. Respir Care. 2013; 58(12): 1838–1844. DOI: 10.4187/respcare.02384

80. Conti G., Cavaliere F., Costa R. и др. Noninvasive ventilation after abdominal surgery: a prospective randomized study. Intensive Care Medicine. 2007. Vol. 33, No. 5. P. 931–938. DOI: 10.1007/s00134‑007‑0591‑5

81. Coppadoro A., Zago E., Pavan F. и др. The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings. Critical Care. 2021. Vol. 25. Art. 327. DOI: 10.1186/s13054021037468

82. Cosentini C., Brambilla A.M., Aliberti S. и др. Helmet Continuous Positive Airway Pressure versus Oxygen Therapy to Improve Oxygenation in CommunityAcquired Pneumonia: A Randomized Controlled Trial. Chest. 2010. Vol. 138, No. 1. P. 114120.

83. CPAP Helmet for COVID19 [Электронный ресурс]. CoDesign Collaborative. 2020. URL: https://codesigncollaborative.org/mms–cpap.

84. Dall’Ago P., et al. Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial. J Am Coll Cardiol. 2006. Vol. 47, No. 4. P. 757–763.

85. Daynes E., Gerlis C., Chaplin E. et al. Early experiences of rehabilitation for individuals post‑ COVID to improve fatigue, breathlessness, exercise capacity and cognition – A cohort study. Chron Respir Dis. 2021; 18: 14799731211015691. DOI: 10.1177/14799731211015691

86. De Troyer A., Boriek A.M. Mechanics of the respiratory muscles. Comprehensive Physiology. 2011. Vol. 1, No. 3. P. 1273–1300.

87. Denehy L., Berney S. The use of positive expiratory pressure (PEP) therapy in clinical practice: evidence and applications. Eur Respir J. 2019. Vol. 54, No. 1. P. 1802189.

88. Dimar S.r.l. Medical Device – NIV and CPAP helmets [Электронныйресурс]. URL: https://dimarspa.com/en/medical–device/.

89. Dolci G., Longhini F., Camporota L. идр. Performance of a novel inflatableframe helmet for noninvasive ventilation: an invitro study. Biomedical Engineering Online. 2023. Vol. 22. Art. 105. DOI: 10.1186/s12938023011059

90. Eaglesports. Инструкция по эксплуатации электронных инспираторных тренажеров серии POWERbreathe K. М., 2022. 36 с.

91. Eaglesports. Профессиональные дыхательные тренажеры POWERbreathe K для медицинской и спортивной реабилитации. М., 2022. 28 с.

92. Elliott M.W., Nava S. NIV and respiratory muscle unloading. HealthManagement. 2020. Vol. 15, No. 2. P. 120–128.

93. FagevikOlsén M., Hahn I., Nordgren S. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg. 1997; 84 (11): 1535–1538. DOI: 10.1002/bjs.1800841111.

94. Failure of noninvasive ventilation in acute respiratory distress syndrome: risk factors and outcomes / G. Carteaux et al. Ann. Am. Thorac. Soc. 2021. Vol. 18, No. 2. P. 1–10.

95. Ferrari G., De Filippi G., Elia F. et al. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. 2014. Vol. 6, No. 1. P. 8. DOI: 10.1186/2036‑7902‑6‑8

96. Ferrer M., Esquinas A., Leon M., et al. Noninvasive ventilation in severe communityacquired pneumonia. JAMA. 2003. Vol. 290, No. 24. P. 3178–3184.

97. Fisher & Paykel Healthcare. Technical Datasheet: Airvo 3 DualModeHighFlow and NIV System. Auckland, 2023. 12 p.

98. Frat J.P., Thille A.W., Mercat A. et al. Highflow oxygen through nasal cannula in acute hypoxemic respiratory failure. The New England Journal of Medicine. 2015. Vol. 372, No. 23. P. 2185–2196.

99. Geddes E.L., O’Brien K., Reid W.D. et al. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: a systematic review. Respir Med. 2008. Vol. 102 (11). P. 1715–1729.

100. Girou E., et al. Pressure ulcers from nasal masks during noninvasive ventilation: incidence and risk factors. Am J Crit Care. 2021; 30 (2): 127–134.

101. Goligher E.C., Fan E., Herridge M.S. et al. Evolution of Diaphragm Thickness During Mechanical Ventilation. Am J Respir Crit Care Med. 2015. Vol. 192, No. 9. P. 1080–1088. DOI: 10.1164/rccm.201503–0620OC

102. Gómez F., Martínez R. Fisiología de la ventilación no invasiva. Rev. Méd. Madrid. 2021. Vol. 13, No. 4. P. 201–209.

103. Gosselink R., et al. Inspiratory muscle training improves exercise performance in elderly. Eur Respir J. 2011. Vol. 37, No. 2. P. 418–425.

104. Grand View Research. Noninvasive Ventilation Market Size, Share & Trends Analysis Report. San Francisco: Grand View Research, 2023. 145 p.

105. Grieco D. L., Menga L.S., Cesarano M. идр. Effect of helmet noninvasive ventilation vs highflow nasal oxygen on days free of respiratory support in patients with COVID19 and moderate to severe hypoxemic respiratory failure: The HENIVOT randomized clinical trial. JAMA. 2021. Vol. 325, No. 17. P. 1731–1743. DOI: 10.1001/jama.2021.4682

106. Grieco D.L., Menga L.S., Roca O. Patient comfort and tolerance during noninvasive ventilation delivered by helmet versus face mask: a narrative review. Current Opinion in Critical Care. 2023. Vol. 29, No. 1. P. 69–76. DOI: 10.1097/MCC.0000000000000999

107. HajGhanbari B., Yamabayashi C., Buna T.R. et al. Effects of respiratory muscle training on performance in athletes: a systematic review with meta – analyses. J Strength Cond Res. 2013; 27(6): 1643–1663. DOI: 10.1519/JSC.0b013e318269f73f

108. Hall J.C., Tarala R.A., Tapper J., Hall J.L. Prevention of respiratory complications after abdominal surgery: a randomised clinical trial. BMJ. 1996; 312(7024): 148–152. DOI: 10.1136/bmj.312.7024.148

109. Hellyer T.P., et al. The intensive care society recommended bundle of interventions for the prevention of ventilator‑associated pneumonia. J Intensive Care Soc. 2016. Vol. 17, No. 3. P. 238–243.

110. Herman A.I., et al. Inspiratory muscle training and seizure control: a pilot study. Epilepsy Behav. 2021. Vol. 122. P. 108170.

111. Hill K., Jenkins S.C., Philippe D.L. et al. Effects of inspiratory muscle training in COPD: systematic review and meta‑analysis. Clin Rehabil. 2010. Vol. 24 (3). P. 277–287.

112. Hill N.S., Lin D., Levy B.L. Noninvasive positive pressure ventilation in acute exacerbations of chronic obstructive pulmonary disease. N. Engl. J. Med. 1994. Vol. 330, No. 13. P. 161–167.

113. Holland A.E., Button B.M., Lee A.L. Airway clearance techniques in bronchiectasis: state of the art review. Respiration. 2015; 89(3): 211–220. DOI: 10.1159/000381754

114. Hong X., Zhang Y., Liu Z. идр. Patient tolerance of helmet versus face mask noninvasive ventilation: a systematic review and meta‑analysis. Respiratory Medicine. 2021. Vol. 189. Art. 106647. DOI: 10.1016/j.rmed.2021.106647

115. Hulzebos E.H., et al. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high‑risk patients undergoing CABG surgery: a randomized clinical trial. JAMA. 2006. Vol. 296, No. 15. P. 1851–1857.

116. Illi S.K., Held U., Frank I. et al. Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta‑analysis. Sports Med. 2012; 42 (8): 707–724. DOI: 10.2165/11631670‑000000000‑00000

117. Intersurgical. StarMedCaStar R hood for NIV [Электронный ресурс]. URL: https://www.intersurgical.com/products/critical-care/starmed-castar-r-hood-for-niv

118. Intersurgical. StarMedCaStar R Up‑Openable hood for NIV [Электронный ресурс]. URL: https://www.openable‑hood‑for‑niv.

119. Italiya S., Rossi G., Colombo A. идр. Prophylactic helmet CPAP after major abdominal surgery: a prospective cohort study. Minerva Anestesiologica. 2012. Vol. 78, No. 10. P. 1116–1124.

120. Ivanov A.V., Petrova M.N., Sokolov D.I. Early application of helmet CPAP after highrisk surgery: singlecenter experience. Russian Journal of Anesthesiology and Reanimatology. 2018. Vol. 63, No. 4. P. 23–29.

121. Ivanov I.V., Petrov P.P. Respiratory muscle training in critically ill patients: a systematic review and meta‑analysis. Frontiers in Medicine. 2023; 10: 1147238. DOI: 10.3389/fmed.2023.1147238.

122. Ivanov P.A., Smirnova E.G. Successful use of StarMed helmet CPAP in a patient with morbid obesity hypoventilation syndrome: case report. Russian Journal of Pulmonology. 2022. Vol. 32, No. 5. P. 87–92. DOI: 10.18093/0869018920223258792

123. Jackson D., Sarki A.M., Betteridge R., Brooke J. Medical devicerelated pressure ulcers: a systematic review and metaanalysis. International Journal of Nursing Studies. 2019. Vol. 92. P. 109–120.

124. Khan M., Shrestha P., et al. Custom 3‑D printed non‑invasive ventilation masks during pandemics. Procedia Engineering. 2021. Vol. 114. P. 101–109.

125. Kim W.Y., Suh H.J., Hong S.B. et al. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011. Vol. 39, No. 12. P. 2627–2630. DOI: 10.1097/CCM.0b013e3182266408

126. Köhnlein T., Windisch W., et al. Leak dynamics in NIV masks. Sleep Breath. 2021. Vol. 25. P. 745–752.

127. Laghi F., Tobin M.J. Disorders of the respiratory muscles. American Journal of Respiratory and Critical Care Medicine. 2003. Vol. 168, No. 1. P. 10–48.

128. Langer D., Charususin N., Jacome C. et al. Efficacy of a novel method for inspiratory muscle training in people with chronic obstructive pulmonary disease. Phys Ther. 2015; 95 (9): 1264–1273. DOI: 10.2522/ptj.20140576

129. Larson J.L., Covey M.K., Wirtz S.E. et al. Cycle inspiratory muscle training in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999; 160 (2): 500–507. DOI: 10.1164/ajrccm.160.2.9810060

130. Larson J. L., Kim M. J., Sharp J. T., Larson D. A. Inspiratory muscle training with a pressure threshold breathing device in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1988; 138(3): 689–696. DOI: 10.1164/ajrccm/138.3.689

131. Laveneziana P., Albuquerque A., Aliverti A., et al. ERS statement on respiratory muscle testing. Eur. Respir. J. 2019. Vol. 53(6). P. 1801214.

132. Lee A.L., Burge A.T., Holland A.E. Positive expiratory pressure therapy versus other airway clearance techniques for bronchiectasis. Cochrane Database Syst Rev. 2017; (9): CD011699. DOI: 10.1002/14651858.CD011699.pub2.

133. Li X.Y., Zhou Z.L., et al. High‑flow nasal cannula in immunocompromised pneumonia. Intensive Care Med. 2022. Vol. 48. P. 112–122.

134. Lin J., Dai Z., et al. AdaptiveSeal smart cushion for NIV masks. IEEE Trans. Med.Devices. 2022. Vol. 8. P. 221–229.

135. Liu K., Zhang W., et al. Respiratory rehabilitation in elderly patients with COVID‑19: A randomized controlled study. Complement Ther Clin Pract. 2020. Vol. 39. P. 101166.

136. Liu Q., Zhang X., Zheng R. идр. Clinical efficacy of helmet versus face mask noninvasive ventilation in patients with acute exacerbation of COPD: a randomized trial. International Journal of COPD. 2020. Vol. 15. P. 2239–2247. DOI: 10.2147/COPD.S263456

137. Lomax M., McConnell A.K. Inspiratory muscle fatigue in swimmers after a single 200 m swim. J Sports Sci. 2003. Vol. 21, No. 8. P. 659–664.

138. Longhini F., Pisani L., Dellacasagrande M. идр. Combined highflow nasal cannula and helmet CPAP improves CO2 washout and comfort: a physiological crossover trial. Annals of Intensive Care. 2022. Vol. 12. Art. 89. DOI: 10.1186/s13613022010620

139. Loring S.H., Malhotra A. Ventilatory drive and lung injury. Am.J. Respir. Crit. Care Med. 2019. Vol. 199, No. 9. P. 1120–1130.

140. Lunardi A.C., Porras D.C., Carvalho C.R.F. et al. Effect of volume‑oriented incentive spirometry on chest wall volumes in patients undergoing abdominal surgery. Phys Ther. 2011; 91(5): 734–742. DOI: 10.2522/ptj.20100176

141. MacIntyre N.R. Physiologic effects of noninvasive ventilation. Respiratory Care. 2019. Vol. 64, No. 6. P. 617–628.

142. Mauri T., Grasselli G., Suriano M. идр. Control of patient‑ventilator asynchrony by neurally adjusted ventilatory assist (NAVA) during noninvasive ventilation delivered by helmet. Intensive Care Medicine. 2013. Vol. 39, No. 11. P. 2035–2043. DOI: 10.1007/s00134‑013‑3047‑4

143. Mauri T., Turrini C., Eronia N. et al. Physiologic effects of highflow nasal cannula in acute hypoxemic respiratory failure. American Journal of Respiratory and Critical Care Medicine. 2017. Vol. 195, No. 9. P. 1207–1215.

144. McConnell A. K., Lomax M. The influence of inspiratory muscle work history and specific inspiratory muscle training upon human limb muscle fatigue. J Physiol. 2006; 577 (Pt 1): 445–457. DOI: 10.1113/jphysiol.2006.118067

145. McConnell A. K., Romer L.M. Respiratory muscle training in healthy humans: resolving the controversy. Int J Sports Med. 2004; 25(4): 284–293. DOI: 10.1055/s‑2004–815827

146. McCool F. D., Rosen M. J. Nonpharmacologic airway clearance therapies: ACCP evidence‑based clinical practice guidelines. Chest. 2006; 129 (1 Suppl): 250S‑259S. DOI: 10.1378/chest.129.1_suppl.250S

147. McIlwaine M., Bradley J., Elborn J.S. et al. Personalising airway clearance in chronic lung disease. Eur Respir Rev. 2017; 26 (143): 160086. DOI: 10.1183/16000617.0086–2016

148. McIlwaine M. P., Alarie N., Davidson G.F. Long‑term use of PEP mask therapy in patients with cystic fibrosis. Respir Care. 2013. Vol. 58, No. 8. P. 1245–1250.

149. Meduri G.U., Schnapp L.M., Lissauer M.E. Continuous positive airway pressure via face mask in acute exacerbations of chronic obstructive pulmonary disease. Am. Rev. Respir. Dis. 1982. Vol. 125, No. 5. P. 617–620.

150. Mehta S., Hill N.S. Noninvasive ventilation. Am J Respir Crit Care Med. 2001; 163(2): 540–577.

151. Menga L.S., Grieco D.L., Cappellini V. идр. Integrated sensing technology in nextgeneration NIV helmets: a benchtobedside evaluation. Journal of Critical Care. 2024. Vol. 76. P. 154–161. DOI: 10.1016/j.jcrc.2024.02.015

152. Merck Sharp & Dohme Corp. Chronic Obstructive Pulmonary Disease: Treatment [Электронныйресурс]. MSD Manual Professional Version. 2024. URL: https://www.msdmanuals.com/professional.

153. Miller M.R., Hankinson J., Brusasco V., et al. Standardisation of spirometry. Eur. Respir. J. 2005. Vol. 26. P. 319–338.

154. Moço P., dos Santos G.J., Pereira I. et al. Dualchannelfibreoptic oxygen and carbon dioxide sensor for noninvasive metabolic monitoring. Sensors. 2023. Vol. 23, No. 14. P. 6451.

155. Moore K.L., Dalley A.F., Agur A.M.R. Clinically Oriented Anatomy. 8th ed. Philadelphia: Lippincott – Williams & Wilkins, 2018.–1168 p.

156. Morgan R.K., McNally S., Alexander M. et al. Sniff nasal inspiratory pressure: normal values and test‑retest reliability. Thorax. 2005. Vol. 60. P. 595–600.

157. National Pressure Ulcer Advisory Panel; European Pressure Ulcer Advisory Panel; Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. 2nd ed. Osborne Park, Western Australia: Cambridge Media, 2014.

158. Nava S., Hill N. Noninvasive ventilation in acute respiratory failure. Lancet. 2009. Vol. 374, No. 9695. P. 250–259.

159. Navalesi P., Fanfulla F., Frigerio P. идр. Patient‑ventilator interaction during noninvasive ventilation delivered by helmet versus facial mask in exacerbation of chronic obstructive pulmonary disease. Intensive Care Medicine. 2007. Vol. 33, No. 6. P. 1104–1112. DOI: 10.1007/s00134‑007‑0610‑6

160. Nishimura M. High‑flow nasal cannula noise characterization. J. Intensive Care. 2019. Vol. 7. 16.

161. NIV SAFE Registry Investigators. Complications associated with noninvasive ventilation interfaces: analysis of 4820 patients. Respiratory Care. 2024. Vol. 69, No. 11. P. 14011410.

162. Ntoumenopoulos G., Presneill J.J., McElholum M. et al. Chest physiotherapy for the prevention of ventilator‑associated pneumonia. Intensive Care Med. 2002; 28(7): 850–856. DOI: 10.1007/s00134‑002‑1342‑2

163. Overend T.J., Anderson C.M., Lucy S.D. et al. The effect of incentive spirometry on postoperative pulmonary complications: a systematic review. Chest. 2001; 120(3): 971–978. DOI: 10.1378/chest.120.3.971

164. Pasquina P., Tramer M.R., Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: systematic review. BMJ. 2003; 327(7428): 1379. DOI: 10.1136/bmj.327.7428.1379.

165. Patel B.K. et al. Helmet noninvasive ventilation vs face mask for ARDS: a randomized clinical trial. JAMA. 2016. Vol. 315, No. 22. P. 2435–2447.

166. Patel S.B., et al. Incentive Spirometry in Postoperative Pulmonary Complication Prevention: A Review. J Clin Anesth. 2021. Vol. 69. P. 110–118.

167. Patil S.P., Maskey A. Noninvasive ventilation in acute cardiogenic pulmonary edema // Chest. 2021. Vol. 160, No. 5. P. 1702–1712.

168. Patroniti N., Saini M., Zanella A. и др. Noise exposure during continuous positive airway pressure delivered by helmet: effects of active noise control and analgesia‑sedation. Anesthesiology. 2011. Vol. 114, No. 6. P. 1410–1418. DOI: 10.1097/ALN.0b013e318218f3af

169. Pavone M., Fanfulla F., De Villa E. Mouthpiece ventilation in neuromuscular disorders: current perspectives // Neuromuscular Disorders. 2021. Vol. 31, No. 5. P. 447–454.

170. Perkins G.D., Ji C., Connolly B. идр. An adaptive randomised controlled trial of noninvasive respiratory strategies in acute respiratory failure patients with COVID‑19 (RECOVERYRS). The Lancet Respiratory Medicine. 2022. Vol. 10, No. 11. P. 1138–1148. DOI: 10.1016/S2213–2600(21)00460‑7

171. Piper A.J., Grunstein R.R. Continuous positive airway pressure therapy in obesity hypoventilation syndrome. Sleep Medicine Reviews. 2015. Vol. 20. P. 79–87.

172. Pisani L., Corcione N., et al. Acoustic burden of helmet ventilation. Intensive Care Med. 2021. Vol. 47. P. 276–284.

173. Pisani L., Mega C., Vaschetto R. идр. Helmet versus face mask for noninvasive ventilation in acute hypercapnic respiratory failure: systematic review and metaanalysis of randomized trials. Critical Care. 2022. Vol. 26. Art. 57. DOI: 10.1186/s13054022‑03964‑9

174. Pisani L., Vega M.L., et al. Leak compensation in helmets. Respir. Physiol. Neurobiol. 2020. Vol. 282. 103508.

175. POWERbreathe Classic Medium Resistance. Бирмингем: Powerbreathe International Ltd., 2022. 18 p.

176. POWERbreathe. Тренажеры для дыхательных мышц. М.: Эйгл Спорт, 2023. 24 с.

177. Principi T., Pantanetti S., Scotti M. идр. Continuous positive airway pressure delivered by helmet for noninvasive ventilation after major abdominal surgery in paediatriconco-hematologic patients: a pilot study. Intensive Care Medicine. 2004. Vol. 30, No. 1. P. 96–101. DOI: 10.1007/s00134‑003‑2043‑3

178. Pryor J.A., Prasad S.A. Physiotherapy for respiratory and cardiac problems: adults and paediatrics. 5th ed. Elsevier, 2019. 648 p.

179. Rabitsch W., Schellongowski P., Hetz H. идр. Non‑invasive ventilation with a helmet in immunosuppressed patients with acute respiratory failure. Bone Marrow Transplantation. 2004. Vol. 34, No. 6. P. 447–451. DOI: 10.1038/sj.bmt.1704637

180. Radovanovic D., Coppadoro A., Franceschi E. и др. Helmet CPAP to treat hypoxemic acute respiratory failure due to COVID‑19: a multicenter cohort study. Critical Care. 2021. Vol. 25. Art. 128. DOI: 10.1186/s13054‑021‑03560‑2

181. Restrepo R.D., Wettstein R., Wittnebel L., Tracy M. Incentive spirometry: 2011. Respir Care. 2011; 56(10): 1600–1604. DOI: 10.4187/respcare.01471

182. Roca O., Caralt B., Messika J. идр. Current evidence for high‑flow nasal cannula in acute respiratory failure and periintubation period. Annals of the American Thoracic Society. 2019. Vol. 16, No. 9. P. 1102–1111. DOI: 10.1513/AnnalsATS.201902–127FR

183. Roca O., Messika J., Caralt B., et al. Predicting Success of HighFlow Nasal Oxygen Therapy: The ROX Index. Am.J. Respir. Crit. Care Med. 2019. Vol. 199, No. 11. P. 1368–1376.

184. Rocco M., Dell’Utri D., Morelli A. идр. Noninvasive ventilation by helmet or face mask in immunocompromised patients with hypoxemic acute respiratory failure: A casecontrol study. Chest. 2004. Vol. 126, No. 5. P. 1508–1515.

185. Rochester C. L., Vogiatzis I., Holland A. E., et al. Enhancing implementation and use of pulmonary rehabilitation. Am.J. Respir. Crit. Care Med. 2015. Vol. 192 (11). P. 1373–1386.

186. Rochwerg B., Brochard L., Elliott M.W., et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017; 50(2): 1602426. DOI: 10.1183/13993003.02426–2016

187. Rochwerg B. et al. ERS/ATS guidelines on noninvasive ventilation in acute respiratory failure. Eur. Respir. J. 2017. Vol. 50. Art. 1602426.

188. Sánchez J., Derenne J.P., Debesse B. et al. Typology of the respiratory muscles in normal men and in patients with moderate chronic respiratory diseases. Bulletin Européen de Physiopathologie Respiratoire. 1982. Vol. 18, No. 6. P. 901–914.

189. Santos L.R., García M., Kumar A. Inspiratory muscle training in subacute respiratory failure: results of a randomized controlled trial // Frontiers in Physiology. 2024; 15: 1265234. DOI: 10.3389/fphys.2024.1265234

190. Sarwal A., Walker F.O., Cartwright M.S. Neuromuscular ultrasound for evaluation of the diaphragm. Muscle Nerve. 2013. Vol. 47, No. 3. P. 319–329. DOI: 10.1002/mus.23671

191. Savci S., et al. Inspiratory muscle training in coronary artery bypass graft surgery patients. J Cardiopulm Rehabil Prev. 2011. Vol. 31, No. 2. P. 105–110.

192. Scala R., Heunks L.M.A. Highlights in acute respiratory failure. Eur Respir Rev. 2018; 27(147): 180008.

193. Scandroglio M., Piccolo U., Mazzone E. и др. Use and nursing of the helmet in delivering non invasive ventilation. Minerva Anestesiologica. 2002. Vol. 68, No. 5. P. 475‑480.

194. Scholten E.L., Beitler J.R., Prisk G.K., Malhotra A. Treatment of ARDS with prone positioning. Chest. 2017; 151(1): 215–224. DOI: 10.1016/j.chest.2016.06.032

195. Scquizzato T., Banfi L., Bonifazi M. и др. Remote monitoring of helmetbased non‑invasive ventilation during the COVID19 pandemic: feasibility and clinical outcomes. Respiratory Medicine. 2023. Vol. 204. Art. 107082. DOI: 10.1016/j.rmed.2023.107082

196. Shamohammadi H., Weaver L., Saffaran S. et al. Airway pressures generated by high flow nasal cannula in patients with acute hypoxemic respiratory failure: a computational study. Respiratory Research. 2025. Vol. 26, Art. 9. P. 1–12.

197. Sheel A.W., Derchak P.A., Morgan B.J., Pegelow D.F., Dempsey J.A. Fatiguing inspiratory muscle work causes reflex sympathetic activation in humans. The Journal of Physiology. 2001. Vol. 537, Pt 3. P. 999‑1008.

198. Simon L., et al. Chest physiotherapy and pain control for rib fractures. Eur J Trauma Emerg Surg. 2015. Vol. 41, No. 3. P. 331–338.

199. Sklienka P., Burša F. Patient selfinflicted lung injury: pathophysiology and management. Physiol. Res. 2023. Vol. 72, No. 3. P. 381–396.

200. Smith J.A., Brown L.M., Taylor R.K. The effect of increased dead space volume on arterial carbon dioxide tension in mechanically ventilated subjects. Am.J. Respir. Crit. Care Med. 2019. Vol. 200, No. 4. P. 456–463. DOI: 10.1164/rccm.201901–0034OC

201. Spruit M. A., et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014. Vol. 44, No. 6. P. 1428–1446.

202. Squadrone V., Coha M., Cerutti E. и др. Continuous positive airway pressure for treatment of postoperative hypoxemia: a randomized controlled study. JAMA. 2005. Vol. 293, No. 5. P. 589–595. DOI: 10.1001/jama.293.5.589

203. Suesada M.M., et al. Inspiratory muscle training in patients with prolonged mechanical ventilation: a randomized trial. Intensive Care Med. 2017. Vol. 43, No. 12. P. 1978–1980.

204. Svenningsen S., Paulin G.A., Sheikh K. et al. Oscillatory positive expiratory pressure therapy in chronic obstructive pulmonary disease and bronchiectasis. Int J Chron Obstruct Pulmon Dis. 2016; 11: 2081–2090. DOI: 10.2147/COPD.S109882

205. Taccone F.S. et al. PaCO2 and alveolar dead space are more relevant than PaO2/FiO2 ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study. Critical Care. 2011. Vol. 15. R74.

206. The University of Chicago Medicine. Helmet ventilation resources for clinicians – SeaLong Medical Systems helmet assembly video [Электронный ресурс]. 2020. URL: https://www.uchicagomedicine.org/health-care-professionals/coronavirusclinician-resources/helmet-ventilation-resources.

207. Thille A.W., Boissier F., Ben Ghezala H., et al. Effect of Postextubation Noninvasive Ventilation on Mortality in Patients at High Risk of Reintubation: A Randomized Clinical Trial. JAMA. 2016. Vol. 315, No. 13. P. 1354–1361.

208. Thille A.W., Boissier F., BenGhezala H., et al. Outcomes of Noninvasive Ventilation Failure in Acute Hypoxemic Respiratory Failure: Application of SOFA and APACHE II Scores. Chest. 2018. Vol. 153, No. 1. P. 217–227.

209. Thille A.W., et al. Patient – ventilator asynchrony during non‑invasive ventilation. Intensive Care Med. 2020; 46(12): 2314–2326.

210. Threshold IMT. Руководство пользователя и технические характеристики. М.: Trimm, 2022. 12 с.

211. Threshold IMT. Тренажер дыхательный. М.: Trimm, 2024. 16 с.

212. Tobin M.J. Comparison of noninvasive and invasive ventilation. JAMA. 2020. Vol. 323, No. 14. P. 1395–1397.

213. Tonelli R., Fantini R., Tabbì L., et al. Inspiratory Effort and Lung Injury in Spontaneously Breathing Patients: The Risk of Patient SelfInflicted Lung Injury (PSILI). Ann. Intensive Care. 2020. Vol. 10, Art. 28.

214. Tonnelier J.M., Prat G., Espitalier F. и др. Clinical evaluation of continuous positive airway pressure delivered using a helmet device in acute cardiogenic pulmonary edema. Intensive Care Medicine. 2010. Vol. 36, No. 1. P. 112–118. DOI: 10.1007/s00134‑009‑1661‑2

215. Toth M.J., et al. Respiratory muscle training after abdominal surgery: a systematic review and meta‑analysis. Ann Surg. 2020. Vol. 271, No. 2. P. 227–237.

216. U.S. Food and Drug Administration. Dimar NIV Helmet и Dimar CPAP Helmet – EUA 20.04.2022 [Электронный ресурс].– URL: https://www.fda.gov/medical‑devices/covid‑19‑emergency‑use‑authorizations‑medical‑devices/ventilators‑and‑ventilator‑accessories‑euas.

217. U.S. Food and Drug Administration. NIVAI™. 510(k) Premarket Notification K240112. Silver Spring, 2024. 48 p.

218. U.S. Food and Drug Administration. Umbrella Emergency Use Authorization for ventilators and ventilator accessories (24.03.2020) [Электронный ресурс]. URL: https://www.fda.gov/medical-devices/covid-19-emergency-use-authorizations-medical-devices/ventilators-and-ventilator-accessories-euas.

219. Umbrello M., Formenti P., Longhi D. et al. ** Ultrasound assessment of diaphragm function in critically ill patients // Critical Ultrasound Journal. 2015. Vol. 7, No. 1. Art. 8.

220. Valkenet K., van de Port I.G., Dronkers J.J. et al. The effects of preoperative inspiratory muscle training in patients undergoing cardiothoracic or abdominal surgery: a systematic review. Clin Rehabil. 2011; 25(3): 213–223. DOI: 10.1177/0269215510380830

221. Vassilakopoulos T. Diaphragm atrophy and noninvasive ventilation: friend or foe? /Curr. Opin. Crit. Care. 2022. Vol. 28, No. 1. P. 43–50.

222. Vital F.M., et al. CPAP versus oxygen in cardiogenic pulmonary edema. Ann. Emerg. Med. 2018. Vol. 71. P. 198–206.

223. Vorona S.; Sabatini U.; AlMaqbali S. et al. nspiratory Muscle Rehabilitation in Critically Ill Adults: A Systematic Review and MetaAnalysis. Annals of the American Thoracic Society. 2018. Vol. 15, No. 6. P. 735–744. DOI: 10.1513/AnnalsATS.201712961OC

224. Walkey A., Del Sorbo L. Noise levels of NIV devices. Ann. Am. Thorac. Soc. 2020. Vol. 17. P. 133–140.

225. Walkey A.J., Del Sorbo L. Delayed intubation in acute respiratory failure. Crit. Care Med. 2021. Vol. 49, No. 6. P. 1025–1036.

226. Wei Y., Pei J., Yang Q. et al. The prevalence and risk factors of facial pressure injuries related to adult noninvasive ventilation equipment: a systematic review and metaanalysis. International Wound Journal. 2023. Vol. 20, No. 3. P. 621–632.

227. Weiner P., McConnell A. Respiratory muscle training in chronic obstructive pulmonary disease: inspiratory or expiratory? Respiration. 2005; 72(5): 505–510. DOI: 10.1159/000087670

228. West J.B. Respiratory Physiology: The Essentials. Philadelphia: Lippincott Williams & Wilkins, 2020. 200 p.

229. West J.B. Respiratory Physiology: The Essentials. Philadelphia: Lippincott Williams & Wilkins, 2020. 200 p.

230. Westerdahl E., Lindmark B., Eriksson T., Friberg Ö., Hedenström H., Tenling A. Deep – breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005; 128 (5): 3482–3488.

231. Winck J.C., Ambrosino N. Respiratory muscle training in neuromuscular disease: experience from the Portuguese program. Chron Respir Dis. 2011. Vol. 8, No. 2. P. 109–118.

232. Xu Q., Luo Y., et al. Meta‑analysis of gas‑exchange efficacy across NIV interface. Intensive Care Med. 2024. Vol. 50. P. 121–135