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NON INVASIVE VENTILATION
DEFINATION
• Noninvasive ventilation refers to the delivery of mechanical
ventilation to the lungs using techniques that do not require invasive
artificial airway(endotracheal tube, tracheostomy)
• EFFECTS OF NIV:
• Improves alveolar ventilation to reverse respiratory acidosis and
hypercarbia
• Recruits alveoli and increases FRC to reverse hypoxia
• Reduces work of breathing
ADVANTAGES
• Application –easy to implement or remove
• Improves patient discomfort
• Reduces the need for sedation
• Oral patency( preserves speech, swallowing,cough)
• Avoids resistive work of ETT
• Avoids complications of ETT like local trauma, aspiration
• Reduced cost and length of stay
DISADVANTAGES
• Slower correction of gas exchange abnormalities
• Mask-facial skin necrosis, air leakage, eye irritation
• Lack of airway access and protection
• Compliance/claustrophobia
• Requires supervision
MODES
• Hypoxemia = CPAP
• Hypercapnia and hypoxia =BiPAP
CPAP(CONTINOUS POSITIVE AIRWAY PRESSURE)
• provides constant positive airway pressure throughout cycle
• improves oxygenation
• decreases work of breathing by alveolar recriutment
• decreases hypoxia by alveolar recruitment and reduces
intrapulmonary shunt
INDICATIONS
• when patient is hypoxic despite medical intervention
• atelactasis-complete or partial collapse of lung
• rib fractures- to stabilise fractures and prevent damage to the lung
• type 1 respiratory failure
• congestive cardiac failure
• cardiogenic pulmonary odema
BIPAP
• bilevel pressure support
• combination of IPAP and EPEP
• A bilevel pressure respond and support patient spontaneous
inhalation(IPAP) and exhalation(EPAP)
• once patient do not start inhaling within a set time,device
automatically start inhalation
• After inhalation device automatically decreases the pressure (EPAP)
for patient exhalation
• ventilation is provided mainly by iPAP whereas ePAP recriuts
underventilated or collapsed alveoli for gas exchange and allows
removal of exhaled gas
INDICATIONS
• type 2 respiratory failure
• acute exacerbation of COPD
• increased work of breathing like in neuromuscular disorder
• weaning from tracheal intubation
CONTRAINDICATIONS
• impaired consciousness, confusion
• inability to protect airway
• excessive secretion or vomiting
• haemodynamic stability
• untreated pneumothorax
• bowel obstruction
• facial trauma, burns , surgery
COMPLICATIONS
• Hypoxia
• reduced cardiac output
• vomiting and aspiration
• pressure areas
• gastric distention
NON INVASIVE VENTILATION.pptx

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NON INVASIVE VENTILATION.pptx

  • 2. DEFINATION • Noninvasive ventilation refers to the delivery of mechanical ventilation to the lungs using techniques that do not require invasive artificial airway(endotracheal tube, tracheostomy) • EFFECTS OF NIV: • Improves alveolar ventilation to reverse respiratory acidosis and hypercarbia • Recruits alveoli and increases FRC to reverse hypoxia • Reduces work of breathing
  • 3. ADVANTAGES • Application –easy to implement or remove • Improves patient discomfort • Reduces the need for sedation • Oral patency( preserves speech, swallowing,cough) • Avoids resistive work of ETT • Avoids complications of ETT like local trauma, aspiration • Reduced cost and length of stay
  • 4. DISADVANTAGES • Slower correction of gas exchange abnormalities • Mask-facial skin necrosis, air leakage, eye irritation • Lack of airway access and protection • Compliance/claustrophobia • Requires supervision
  • 5. MODES • Hypoxemia = CPAP • Hypercapnia and hypoxia =BiPAP
  • 6. CPAP(CONTINOUS POSITIVE AIRWAY PRESSURE) • provides constant positive airway pressure throughout cycle • improves oxygenation • decreases work of breathing by alveolar recriutment • decreases hypoxia by alveolar recruitment and reduces intrapulmonary shunt
  • 7. INDICATIONS • when patient is hypoxic despite medical intervention • atelactasis-complete or partial collapse of lung • rib fractures- to stabilise fractures and prevent damage to the lung • type 1 respiratory failure • congestive cardiac failure • cardiogenic pulmonary odema
  • 8. BIPAP • bilevel pressure support • combination of IPAP and EPEP • A bilevel pressure respond and support patient spontaneous inhalation(IPAP) and exhalation(EPAP) • once patient do not start inhaling within a set time,device automatically start inhalation • After inhalation device automatically decreases the pressure (EPAP) for patient exhalation • ventilation is provided mainly by iPAP whereas ePAP recriuts underventilated or collapsed alveoli for gas exchange and allows removal of exhaled gas
  • 9. INDICATIONS • type 2 respiratory failure • acute exacerbation of COPD • increased work of breathing like in neuromuscular disorder • weaning from tracheal intubation
  • 10. CONTRAINDICATIONS • impaired consciousness, confusion • inability to protect airway • excessive secretion or vomiting • haemodynamic stability • untreated pneumothorax • bowel obstruction • facial trauma, burns , surgery
  • 11. COMPLICATIONS • Hypoxia • reduced cardiac output • vomiting and aspiration • pressure areas • gastric distention