Non Invasive Ventilation

Introduction

Mechanical ventilation that does not require endotracheal intubation

Modes

  • Continuous positive airway pressure (CPAP)

  • Biphasic positive airway pressure (BiPAP)

 

Indications

  • Respiratory failure that is potentially reversible within 24 hours

  • Cardiogenic pulmonary oedema and exacerbation of obstructive airways disease

  • Reduce work of breathing in fatigued patients

  • Post extubation hypoxaemic states

  • Acute respiratory failure where intubation is inappropriate (or too hazardous)

      • Cystic fibrosis and advanced destructive or obstructive lung disease states

      • Febrile neutropaenia with pulmonary infiltrates (including Pneumocystis jiroveci)

  • Adjunct to weaning from formal ventilation

 

Pre-requisites

  • The patient must be able to protect their own airway and accept a face/nasal mask

  • There must be a reversible problem requiring "bridging" respiratory support

 

Complications

  • Aerophobia or gastric distention

  • Aspiration lung injury

  • Mask intolerance and heightened anxiety

  • Pressure necrosis of the face

  • Failure requiring intubation

 

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Page last reviewed: 13 May 2014
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