How to set up Non-Invasive Ventilation (NIV)

 

Who Needs It?

  1. Patients with moderate to severe COPD exacerbations
  2. Those patients with cardiogenic pulmonary edema with increased work of breathing or hypercapnia
  3. Patients with isolated blunt thoracic trauma
  4. The immunocompromised patient with hypoxic respiratory failure
  5. Patients who require pre-oxygenation prior to intubation

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NIV: What’s the big deal?

 

Terminology:

In general,
Type 1 RF requires CPAP type of NIV.

Type 2 RF requires BPAP type of NIV.

PEEP=EPAP=CPAP i.e. they all mean the same!

So you can say in Type 1 RF(Hypoxic failure), the pressure we provide is PEEP or just EPAP or CPAP. 

For Type 2 RF (Hypercapnic), we provide IPAP as well as EPAP. IPAP is greater than EPAP, PS (Pressure Support is the difference between IPAP and EPAP). For instance if IPAP = 15 and EPAP is 10 then PS = 15-10 i.e. 5cm H2O.