What is non-invasive positive-pressure ventilation?
Non- invasive positive-pressure ventilation (NIPV) uses a ventilator (breathing machine) to help move air into and out of the lungs. Non-invasive ventilation is delivered through a tight-fitting facial or nasal mask, and is pressure assisted to help keep the airways open during inspiration and expiration.
NIPV is commonly used in two specific situations:
- Respiratory emergencies
- Long term management of chronic respiratory conditions
Types of non-invasive ventilation
The two most common non-invasive ventilation machines used are:
- Continuous positive airway pressure (CPAP) – this type of ventilation requires the patient to take spontaneous breaths for which it provides positive pressure to assist inhalation (breathing in). Exhalation (breathing out) is then carried out against the same pressure.
- Bi-level positive airway pressure (BiPAP) – this method allows different pressures to be set for inhalation (breathing in) and exhalation (breathing out). BiPAP is able to provide a lower expiratory pressure, making breathing out easier as the patient doesn’t have to overcome the same level of pressure used to assist inhalation. This is particularly useful in those patients who struggle to overcome the resistance present during exhalation on a CPAP system.
What are the benefits of non-invasive ventilation?
When used in patients with sleep apnoea, there can be a number of positive effects primarily due to the enhanced quality of sleep achieved. These include better quality of life due to reduced fatigue, this can result in enhanced memory, greater job satisfaction and enhances mood.
When used in emergency cases the benefits include:
- Maintenance of airways
- Reduced work of breathing
- Reduced effort required by patient
- Facilitation of ventilation
- Reduces need for intubation
- Can be used in combination with other treatments – manual or medication
Who would benefit from non-invasive ventilation?
Non-invasive ventilation can be used with supplemental high-flow oxygen to assist breathing in cases of severe respiratory distress. Conditions include:
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