Get Manny Non Invasive Vent Workbookdoc

For the first 24 hours you will be required to wear the NIV mask for as long as possible. As your condition improves the specialist team would look to reduce how often in the day you need to wear the mask, with the goal to remove it completely.

NIV works by creating a positive airway pressure - the pressure outside the lungs being greater than the pressure inside of the lungs. This causes air to be forced into the lungs (down the pressure gradient), lessening the respiratory effort and reducing the work of breathing.

Potential detrimental physiologic effects of NIV are ventilator-induced lung injury, auto-PEEP development, and discomfort/muscle overload from poor patient–ventilator interactions.

NIV is particularly indicated in: COPD with a respiratory acidosis pH 7.25–7.35 (H+ 45–56 nmol/l) Hypercapnic respiratory failure secondary to chest wall deformity (scoliosis, thoracoplasty) or neuromuscular diseases. Cardiogenic pulmonary oedema unresponsive to CPAP. Weaning from tracheal intubation.

Most patients will only use NIV for parts of the day or night. However, some are dependent on NIV 24 hours of the day. For these patients, withdrawal of their NIV may cause distressing symptoms and death may occur soon after withdrawal. For these reasons forward planning is required.

Starting NIV settings Start EPAP at 4 or 5 cmH2O. Start IPAP at 10 cmH2O titrated rapidly in 2-5 cm increments at a rate of approximately 5cmH2O each 10 minutes with a usual pressure target of 20cms H2O or until a therapeutic response is achieved or patient tolerability has been reached.

Results: Out of 100 patients, 76 (76%) managed successfully with non-invasive ventilation and 24 patients (24%) needed intubation and invasive mechanical ventilation in this study. Majority of patients (76%) were with clinical diagnosis of Chronic Obstructive Pulmonary Disease.