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.

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