Non-invasive ventilation ( NIV ) is the use of airway support provided through a face mask (nose) rather than an endotracheal tube. The inhaled gas is administered with a positive end-expiratory pressure often with pressure support or with the help of ventilation control at volume and tidal tidal rates. Numerous studies have shown this technique to be as effective as, and better tolerance of, intubation and mechanical ventilation in patients with COPD exacerbations. This is called "non-invasive" because it is delivered with a mask that is fixed tightly in the face, but without the need for tracheal intubation. While there is a similarity with respect to the interface, the NIV is not the same as continuous positive air pressure (CPAP), which implements a positive air pressure level throughout the entire breathing cycle; CPAP does not provide ventilation but is sometimes used in conditions that are also treated with NIV.
Video Non-invasive ventilation
Medical use
NIV can be used in acute and long-term. In some people who experience acute respiratory failure, there is a sustained need for long-term use of NIV at home.
Acute
NIV for acute respiratory failure is used primarily for severe exacerbations in chronic obstructive pulmonary disease (COPD) but also for acute decompensated heart failure and other acute conditions. In acute cardiogenic pulmonary edema caused by decompensated cardiac failure, the quality of evidence is poor but research has shown a decreased risk of death and decreased need for tracheal intubation for both NIV and CPAP.
Chron/home
Chronic use of NIV ("NIV home") may be indicated for severe COPD.
Home NIV can also be indicated in people with neuromuscular disease and chest wall deformities. People with obesity hypoventilation syndrome often require NIV initially in their care, but many can switch to CPAP.
People with motor neurone disease (MND) may require NIV homes in the course of their illness. Guidelines in the United Kingdom establish that assessment of respiratory function is part of multidisciplinary management of MND.
Maps Non-invasive ventilation
Terminology
A number of terms have been used in the medical literature to describe NIV. More formal names of non-invasive positive pressure ventilation (NPPV or NIPPV) have been used to differentiate it from the use of negative pressure ventilators that are now very scarce (â € Å"the new ironâ €). The BiPAP/BIPAP brand name has also enjoyed a level of popularity, once the original NIV engine was manufactured by Respironics, but its use is now discouraged.
History
Non-invasive ventilation has been in use since the 1940s for various indications, but its current use for chronic respiratory problems dates back to the 1980s for people with chronic respiratory muscle weakness, and in the 1990s in intensive care and regulatory units other acute care for acute respiratory failure.
Since 2000 acute NIV has been used extensively in the treatment of acute respiratory failure, especially in people with COPD, including in general wards rather than intensive care unit settings. In the UK, the 2017 report by NCEPOD found that there was a widespread problem in delivering high quality care to patients.
References
Source of the article : Wikipedia
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