Non-invasive pulmonary ventilation

The possibility of performing lung ventilation techniques without the need for invasive airway management - using an oxygen mask with a sealing cuff or an oxygen helmet.

Non-invasive pulmonary ventilation (NIPV) has the task of:

• Short-term → reduce respiratory rate, increase volume, improve gas exchange and reduce the patient's work of breathing.
• In the long term → increased sleep quality, better quality of life, increased survival time.

Most often used:

• CPAP therapy.
• Positive pressure ventilation.
• Diaphragm stimulation.

Indication

• Acute respiratory failure, pulmonary edema.
• COPD.
• Sleep apnea.
• Neurological onem., condition after encephalitis.
• Patients before lung transplantation in the terminal stage.
• Myopathy.

Contraindications:

• Circulatory instability, AIM.
• Risk of aspiration.
• Inability to clear a cough.
• Mask leak.
• Uncooperative and aggressive patients.

Indication to interrupt NIV

• Mask intolerance.
• Progression of the condition within 30 min. up to 1h, development of circulatory instability, deterioration of consciousness.
• Inability to clear a cough.

Complications

• Skin defects, facial erythema, soreness.
• Drying of the mucous membranes due to insufficient moisturizing.
• Stomach distension.
• Leakage of breathing mixture.

Execution

1. Patient education – explanation of the procedure and reason for NIVS, agreement on the method of communication.
2. Preparing the mask - choosing the size and fan - selecting the mode and humidification.
3. Patient monitoring.
4. Semi-sitting position.
5. Connect the mask to the fan and start the mode.
6. Putting on and fixing the mask on the patient's face.
7. We increase pressure support and PEEP gradually.
8. Editing alarms and parameters.
9. NIVS effectiveness check - light sedation can be administered if ventilation is not tolerated.

Links

Related Articles

• Airway Management Overview
• Intubation - in children
• Endotracheal intubation
• Difficult intubation
• Tracheostomy
• Coniotomy
• Laryngospasm
• Artificial pulmonary ventilation/SŠ (nurse)
• Patient/client monitoring at UPV/SŠ (nurse)
• Oxygen Therapy
• PEEP
• Lung volumes

References

• DOSTÁL, Pavel, et al. Základy umělé plicní ventilace. 2., rozšířené edition. Maxdorf Jessenius, 2005. ISBN 80-7345-059-3.