NON INVASIVE VENTILATION
MR. SHEBIN LATHEEF C
SENIOR RESPIRATORY THERAPIST
PRS HOSPITAL, TRIVANDRUM
Non-Invasive Ventilation (NIV) is a form of respiratory support that delivers air or
oxygen to the lungs through a mask or nasal prongs without the need for an
invasive procedure such as intubation.
The goal of NIV is to improve breathing and reduce the work of breathing in patients
with respiratory failure or difficulty breathing.
GOALS
• To improve oxygenation
• To improve ventilation
• To reverse hypoxemia
• To reverse acute respiratory failure
• To provide relief for respiratory distress
• To reverse respiratory muscle fatigue
• To improve pulmonary mechanics
• To prevent or reverse atelectasis
• To improve lung compliance
INDICATIONS
• Acute exacerbation of COPD
• Pulmonary edema
• Weaning
• Immuno-compromised patients
• Pre and post operative respiratory failure
• Pneumonia
• Asthma exacerbation
CONTRAINDICATIONS
• Lack of cooperation
• Cardiac arrest
• Respiratory arrest
• Excessive secretions
• Inability to fit in a mask
• Inability to protect the airway
• Severe facial burns or trauma
COMPLICATIONS
• Abdominal distension
• Airway dryness
• Aspiration
• Claustrophobia
• Decreased cardiac output
• Dry mouth
• Secretion build-up inside the mask
• Eye irritation from an air leak
• Pressure sores from mask, tubing, and strap
• Pressure points
TYPES OF MASK
There are four primary types of interfaces, each with unique benefits tailored to
patient needs and preferences:
• Nasal Mask
• Oro-nasal Mask
• Nasal Pillows
• Full-Face Mask
ORONASAL MASK NASAL PILLOW
HYBRID NASK HELMET MASK
VENTED NON-VENTED NIVMASK
• SIZE SELECTON
• The two-finger rule: when the headgear is attached it should be possible to pass
two fingers beneath it
• Example for skin protection: (a self-cut foam dressing on a head model)
CPAP & BiPAP
The primary types include:
• Continuous positive airway pressure (CPAP)
• Bilevel positive airway pressure (BiPAP) – ( It include IPAP & EPAP)
CPAP
• Continuous positive airway pressure (CPAP) is a type of non invasive ventilatory
support that maintains a constant pressure above atmospheric levels throughout
the entire breathing cycle
• This continuous pressure helps to keep the airways open, thereby preventing
collapse and facilitating easier breathing
• CPAP is frequently used for patients with sleep apnea, as it effectively prevents
apneic episodes by maintaining airway patency
BiPAP
• Bilevel positive airway pressure (BiPAP) is a form of noninvasive ventilation that
provides two distinct levels of pressure support
• The primary goal of BiPAP is to alleviate acute respiratory failure without the need for
an artificial airway
• IPAP – EPAP = PS
How to set & change the NIV settings ?
MODES
MODES PARAMETERS
CPAP CPAP
S IPAP & EPAP
S/T IPAP, EPAP, RR & Inspiratory time
APPLICATION OF NIV
• Inform the patient
• Select the appropriate size of mask
• Select the appropriate mode and settings
• Allow the patient to feel the pressure before applying
• Hold the mask with your hand for few minutes
• Tie the mask properly – not too loose or tight
• Care of pressure points
• Check for air leaks and readjust the strap
• Close monitoring of patients breathing pattern, vitals & metal status
• Documentation
MONITORING
MONITORING
• Breathing pattern
• Vital signs
• GCS
• Tidal volume
• Leaks
• NIV mode & settings - ( including duration)
• Alarms
• Battery backup of machine
• Communication
PATIENT COMFORT IS IMPORTANAT