Non-invasive ventilation (NIV) is a method of delivering respiratory support without the need for invasive procedures like endotracheal intubation. It typically involves wearing a mask or nasal prongs connected to a ventilator that delivers air or a mixture of air and oxygen to the lungs. NIV is commonly used to treat respiratory conditions such as chronic obstructive pulmonary disease (COPD), pneumonia, and acute respiratory distress syndrome (ARDS). It helps improve oxygenation, reduce work of breathing, and relieve respiratory distress, while allowing patients to remain conscious and communicate. NIV can be administered in various settings, including hospitals, intensive care units, and at home, depending on the patient's condition and needs.
2. CONTENT
Introduction of NIV
Indication of NIV
Contraindication of NIV
Types of NIV
Types of NIV masks
Settings in NIV
Benefits of NIV
Challenges and complications
3. INTRODUCTION OF NIV
Definition
The delivering of mechanical ventilation without using a invasive artificial
airway such as endotracheal and tracheostomy tubes.
History:
Non-invasive ventilation (NIV) was first reported in the mid-eighteen century by a
Scottish physician, John Dalziel.In 1864, Alfred F. Jones' patented the first
American tank respirator in the iron lung, known as non-invasive negative
pressure ventilation. In 1938 a new form of NIV was described by Barach et al.
as a treatment for pulmonary edema.
8. CPAP
Continuous positive airway pressure – mask keep your airways
continuously allowing the air in and out of the lungs.
HOW DOES THE CPAP WORKS?
The CPAP machine blows normal air at a fixed or prescribed pressure. The
necessary pressure is usually calculated after review of a sleep study
supervised by a sleep physiologist during an overnight stay.
The mask is held in place by straps or a mesh cap (headgear) to ensure a
good seal around the nose and/or mouth.
9. CONT…
MECHANISM OF ACTION
1. Maintaining airway patency
2. Improving lung compliance and oxygenation
3. Redistribution of pulmonary blood flow
4. Decreasing cardiac workload
5. Preventing atelectasis and V/Q mismatch
10. CONT…
INDICATION OF CPAP
When a patient remains hypoxic despite medical intervention
Atelectasis - Complete or partial collapse of a lung or lobe
Rib fractures - to splint the rib cage open; to stabilise the fracture and prevent
damage to the lung[
Type I respiratory failure
Congestive Heart Failure
Cardiogenic pulmonary edema
Obstructive sleep apnea
Pneumonia: as an interim measure before invasive ventilation or as a ceiling
of treatment
Nasal CPAP is more commonly used with infants
11. BiPAP
NIV often described as BiPAP
In BiPAP there is different airway pressure depend on the inspiration and
expiration
The inspiratory positive airways pressure (iPAP) is higher than the
expiratory positive airways pressure (ePAP)
ventilation is provided mainly by iPAP, whereas ePAP recruits
underventilated or collapsed alveoli for gas exchange and allows for the
removal of the exhaled gas
12. CONT…
INDICATION OF BiPAP
Type II respiratory failure
Acidotic exacerbation of chronic obstructive pulmonary disease (COPD)
Increased work of breath causing ventilatory failure, for example,
hypercapnia (increased CO2 in arterial blood gas), fatigue or
neuromuscular disorder
Weaning from tracheal intubation
13. CONT…
MECHANISM OF ACTION
1. Dual pressure support
2. Improving ventilation and oxygenation
3. Enhancing patient comfort and tolerance
4. Treating OSA
5. Management of RF
17. BENEFITS OF NIV
Improve gas exchange
Avoid intubation
Decrease mortality
Decrease length of time on ventilation
Decrease length of hospitalization
Reduce risk of complication
Improve patient comfort and tolerance
