Noninvasive Mechanical Ventilation

2017 ◽  
Author(s):  
John W. Kreit
Keyword(s):  
Mechanical Ventilation ◽  
Noninvasive Ventilation ◽  
Positive Pressure Ventilation ◽  
Face Mask ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Noninvasive Mechanical Ventilation ◽  
Detailed Explanation ◽  
Life Saving ◽  
Different Types

Although so-called invasive ventilation can be life-saving, it can also cause significant morbidity. It has long been recognized that positive pressure ventilation can also be delivered “non-invasively” to critically ill patients through several different types of “interfaces” (usually a tight-fitting face mask). Noninvasive Mechanical Ventilation explains when and how to use noninvasive ventilation to treat patients with respiratory failure. It provides a detailed explanation of how noninvasive (bi-level) ventilators differ from the standard ICU ventilators, describes the available modes and breath types as well as the indications and contraindications for noninvasive ventilation, and explains how to initiate, monitor, and adjust noninvasive ventilation.

Noninvasive Positive Pressure Ventilation

2019 ◽  
pp. 846-849
Author(s):  
Karen W. Hampton
Keyword(s):  
Noninvasive Ventilation ◽  
Closed System ◽  
Tracheostomy Tube ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Face Mask ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Peak Inspiratory Flow ◽  
Full Face

Noninvasive positive pressure ventilation, also called noninvasive ventilation (NIV), is delivered through a noninvasive device, such as a full-face mask. Unlike the systems for invasive ventilation, which is delivered through an endotracheal or tracheostomy tube, the NIV delivery system is not a closed system, and so it leaks. The size of the leak affects the tidal volume delivered and the ability of the patient to trigger the machine into inspiration or cycle the machine into expiration. The acceptable leak for most systems is less than 35% of the peak inspiratory flow (leakage may be expressed as a percentage or as liters per minute).

scholarly journals A Rare Case of ARDS Caused by Bupropion Inhalation and Treated with Noninvasive Ventilation

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Yousif Al-Saiegh ◽  
Jenna Spears ◽  
Pieter S. De Klerk ◽  
Joshua Hitchings ◽  
Christopher Lee ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Mortality Rate ◽  
Noninvasive Ventilation ◽  
Complete Resolution ◽  
Rare Case ◽  
Positive Pressure Ventilation ◽  
Distress Syndrome ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Invasive Ventilation

Acute respiratory distress syndrome, characterized by the Berlin criteria, is associated with a high mortality rate. Its treatment includes addressing the underlying etiology, general supportive measures, and achievement of effective oxygenation. New key data indicates that in a subset of patients, noninvasive ventilation techniques can be a therapeutic and equivalent alternative to traditional invasive ventilation. We present a rare case of ARDS triggered by nasal bupropion inhalation and effectively treated with noninvasive positive pressure ventilation resulting in complete resolution.

scholarly journals Intermittent Abdominal Pressure Ventilation: An Alternative for Respiratory Support

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Giuseppe Fiorentino ◽  
Anna Annunziata ◽  
Antonietta Coppola ◽  
Antonella Marotta ◽  
Francesca Simioli ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Positive Pressure Ventilation ◽  
Face Mask ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Abdominal Pressure ◽  
New Device ◽  
Ventilation Technique ◽  
Lateral Sclerosis

Intermittent abdominal pressure ventilation is a positive pressure ventilation technique that works with abdominal compressions. It has been known since 1938; however, for many years, it was out of production. In recent years, a new device has been produced that has captured the attention to this old respiratory support technique. We considered eight patients with respiratory failure secondary to a neuromuscular disease (congenital myopathy, Duchenne dystrophy, and amyotrophic lateral sclerosis) intolerant to daytime noninvasive ventilation (NIV). IAPV was proposed as an alternative to NIV. We performed baseline and post-IAPV respiratory function assessment. All patients, two years later, are still using intermittent abdominal ventilation. Intermittent positive abdominal mechanical ventilation can be a valid alternative to noninvasive mechanical ventilation with a nasal or face mask. It improves gas exchange, symptoms, and quality of life, decreases the incidence of pneumonia, and can avert the need for intubation and tracheotomy.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

Comparing positive pressure ventilation efficacy of a novel foot operated resuscitator with self-inflating bag and mask in a manikin model

2020 ◽  
Vol 6 (2) ◽  
pp. 48-54
Author(s):  
Somashekhar Marutirao Nimbalkar ◽  
Binoy Viresh Shah ◽  
Amee Atulkumar Amin ◽  
Vishwa Tushar Patel ◽  
Ajay Gajanan Phatak
Keyword(s):  
Neonatal Intensive Care ◽  
Positive Pressure Ventilation ◽  
Pressure Sensors ◽  
Peak Inspiratory Pressure ◽  
Comparative Trial ◽  
Face Mask ◽  
Target Range ◽  
Positive Pressure ◽  
Medical Systems ◽  
Inspiratory Time

AimTo compare positive pressure ventilation efficacy of a novel foot operated resuscitator (FOR) during positive pressure ventilation with that of self-inflating bag and mask (SIBM) using a manikin model.MethodA comparative trial was conducted with 117 participants at a level III neonatal intensive care unit using Baby Anne (Laerdal Medical, Norway). Flow and pressure sensors were used to measure tidal volume propelled (Vp) and delivered (Vt). Each participant delivered 60 breaths, using each device targeting adequate chest-rise defined as that corresponding to a Vt of 15–21 mL. Vt, Peak Inspiratory Pressure (PIP), Leak Percentage (%), Inspiratory Time (Ti, millisecond) and other parameters were recorded using a PC (Dell, Windows V.10) on a custom application (LabView 2014 platform NI, USA). The proportion of breaths achieving target range Vt, other key ventilation parameters and their variability were compared between a generic CE approved bag and mask and a novel FOR (NeoBreathe, Phoenix Medical Systems, India).ResultUsing an SIBM, participants delivered a mean (SD) Vt of 17.52 (5.22) mL, achieving target range Vt in 46.99% of all breaths, with a mean (SD) face-mask leak per cent of 32.51% (22.25). Using the FOR, participants delivered a mean (SD) Vt of 18.31 (3.90), achieving target range Vt in 54.37% of all breaths and a mean (SD) face-mask leak per cent of 18.89% (14.45). Variability of Vt, PIP and leak per cent was significantly reduced with FOR.ConclusionFOR significantly reduced face-mask leak, significantly increased the proportion of breaths achieving Vt within optimal range and could offer a novel alternative to a SIBM.

scholarly journals Trimming the need for invasive ventilation: pragmatic critical care during the COVID-19 pandemic

2020 ◽  
Vol 13 (9) ◽  
pp. e237597
Author(s):  
Connor P Oates ◽  
Sarah A Goldman ◽  
Gennaro Giustino ◽  
Martin E Goldman
Keyword(s):  
Critical Care ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Medical Professionals ◽  
Religious Leaders ◽  
Invasive Ventilation ◽  
Facial Hair ◽  
Non Invasive ◽  
Hypoxic Respiratory Failure ◽  
Religious Reasons

COVID-19 has challenged all medical professionals to optimise non-invasive positive pressure ventilation (NIV) as a means of limiting intubation. We present a case of a middle-aged man with a voluminous beard for religious reasons who developed progressive hypoxic respiratory failure secondary to COVID-19 infection which became refractory to NIV. After gaining permission to trim the patient’s facial hair by engaging with the patient, his family and religious leaders, his mask fit objectively improved, his hypoxaemia markedly improved and an unnecessary intubation was avoided. Trimming of facial hair should be considered in all patients on NIV who might have any limitations with mask fit and seal that would hamper ventilation, including patients who have facial hair for religious reasons.

Comparison of Early Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in Preterm Infants with Respiratory Distress Syndrome

2018 ◽  
Vol 65 (4) ◽  
pp. 352-360 ◽  
Author(s):  
Mesut Dursun ◽  
Sinan Uslu ◽  
Ali Bulbul ◽  
Muhittin Celik ◽  
Umut Zubarioglu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure

Abstract Aims To compare the effect of early nasal intermittent positive pressure ventilation (nIPPV) and nasal continuous positive airway pressure (nCPAP) in terms of the need for endotracheal ventilation in the treatment of respiratory distress syndrome (RDS) in preterm infants born between 24 and 32 gestational weeks. Methods This is a randomized, controlled, prospective, single-centered study. Forty-two infants were randomized to nIPPV and 42 comparable infants to nCPAP (birth weight 1356 ± 295 and 1359 ± 246 g and gestational age 29.2 ± 1.7 and 29.4 ± 1.5 weeks, respectively). Results The need for endotracheal intubation and invasive mechanical ventilation was significantly lower in the nIPPV group than the nCPAP group (11.9% and 40.5%, respectively, p < 0.05). There were no differences in the duration of total nasal respiratory support, duration of invasive mechanical ventilation, bronchopulmonary dysplasia or other early morbidities. Conclusion nIPPV compared with nCPAP reduced the need for endotracheal intubation and invasive mechanical ventilation in premature infants with RDS.

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