RESP 2310 Chapter 49 – Noninvasive Ventilation (NIV) Study
Guide
What is non-invasive ventilation?
What does it include? - Correct answer✅✅ -It supports ventilation without artificial airway
--may be provided without a rate (patient must initiate all breaths)
--bag-mask provides the earliest example (patient is NOT intubated)
-NIV includes:
--Non-invasive Positive Pressure Ventilation (NPPV) => may also be referred to as BIPAP
--the non-invasive application of Continous Positive Airway Pressure (CPAP)
What are the goals and benefits of using NIV in the acute care setting? - Correct answer✅✅ -improve
gas exchange
-avoid intubation
-decrease mortality
decrease length of hospitalization
-improve survival by decreasing length of ventilator time
-decrease incidence of ventilator-associated pneumonia
-relieve symptoms of respiratory distress
-improve patient-ventilator synchrony
-maximize patient comfort
What are the goals and benefits of using NIV in long-term care setting? - Correct answer✅✅ -
improve/enhance quality of life
-relieve/improve symptoms of hypoventilation
-avoid hospitalization
-increase survival
-improve mobility
,What are the acute care indications for NIV? - Correct answer✅✅ -*hypercapnic respiratory failure
due to COPD*
-asthma
-weaning from vent for COPD
-hypoxemic respiratory failure
-*acute cardiogenic pulmonary edema*
-pneumonia
-acute lung injury and ARDS
-immunosuppressed patients
-palliative care and DNI
-*postoperative use*
-*prevention of reintubation in high-risk patients*
-postextubation respiratory failure
* COPD as an acute care indication for NIV - Correct answer✅✅ -Hypercapnic respiratory failure due
to COPD is the primary indication for NIV
-There is strong evidence of efficancy in reducing:
--need for intubation (once on a vent COPD patient's have a hard time coming off)
--hospital mortality and length of stay
--complications
-NIV is the first-line therapy, it is the standard of care managing an acute exacerbation (quick worsening
onset) of COPD
--if patient gets sick it can quickly worsen their condition
Asthma as an acute care indication for NIV - Correct answer✅✅ -evidence is inconclusive
-use remains controversial
-varies from patient to patient
, Weaning from vent for COPD patients as an acute care indication for NIV - Correct answer✅✅ -COPD
patients who failed SBT (spontaneous breathing trial)
-NIV can lower mortality after 60 days
-Patients can be extubated directly to NIV (instead of a tracheostomy patients can attempt an NIV to
prevent an invasive procedure)
-Patients selected should have used NIV previously and should meet none of the NIV exclusion criteria
Hypoxemic respiratory failure as an acute care indication for NIV - Correct answer✅✅ Hypoxemic
respiratory failure (problem oxygenating)
-Clinical trials of NIV to manage acute hypoxemic respiratory failure have yielded conflicting results
-depends on patient
*Acute cardiogenic pulmonary edema as an acute care indication for NIV - Correct answer✅✅ Acute
cardiogenic pulmonary edema (excess fluid in their pulmonary system)
-Is effective, therapy is provided:
--Mask CPAP of 8 to 12 cm H2O and 100% O2 is first-line therapy to treat hypoxemia associated with
severe cardiogenic pulmonary edema
--NPPV should be reserved for those with both hypercapnia and hypoxemia
Pneumonia as an acute care indication for NIV - Correct answer✅✅ -Only improves outcomes for
COPD patients who develop pneumonia
Acute lung injury(ALI) and ARDS as an acute care indication for NIV - Correct answer✅✅ NIV ususally
doesn't support routine use (usually need mech. ventilation):
Guide
What is non-invasive ventilation?
What does it include? - Correct answer✅✅ -It supports ventilation without artificial airway
--may be provided without a rate (patient must initiate all breaths)
--bag-mask provides the earliest example (patient is NOT intubated)
-NIV includes:
--Non-invasive Positive Pressure Ventilation (NPPV) => may also be referred to as BIPAP
--the non-invasive application of Continous Positive Airway Pressure (CPAP)
What are the goals and benefits of using NIV in the acute care setting? - Correct answer✅✅ -improve
gas exchange
-avoid intubation
-decrease mortality
decrease length of hospitalization
-improve survival by decreasing length of ventilator time
-decrease incidence of ventilator-associated pneumonia
-relieve symptoms of respiratory distress
-improve patient-ventilator synchrony
-maximize patient comfort
What are the goals and benefits of using NIV in long-term care setting? - Correct answer✅✅ -
improve/enhance quality of life
-relieve/improve symptoms of hypoventilation
-avoid hospitalization
-increase survival
-improve mobility
,What are the acute care indications for NIV? - Correct answer✅✅ -*hypercapnic respiratory failure
due to COPD*
-asthma
-weaning from vent for COPD
-hypoxemic respiratory failure
-*acute cardiogenic pulmonary edema*
-pneumonia
-acute lung injury and ARDS
-immunosuppressed patients
-palliative care and DNI
-*postoperative use*
-*prevention of reintubation in high-risk patients*
-postextubation respiratory failure
* COPD as an acute care indication for NIV - Correct answer✅✅ -Hypercapnic respiratory failure due
to COPD is the primary indication for NIV
-There is strong evidence of efficancy in reducing:
--need for intubation (once on a vent COPD patient's have a hard time coming off)
--hospital mortality and length of stay
--complications
-NIV is the first-line therapy, it is the standard of care managing an acute exacerbation (quick worsening
onset) of COPD
--if patient gets sick it can quickly worsen their condition
Asthma as an acute care indication for NIV - Correct answer✅✅ -evidence is inconclusive
-use remains controversial
-varies from patient to patient
, Weaning from vent for COPD patients as an acute care indication for NIV - Correct answer✅✅ -COPD
patients who failed SBT (spontaneous breathing trial)
-NIV can lower mortality after 60 days
-Patients can be extubated directly to NIV (instead of a tracheostomy patients can attempt an NIV to
prevent an invasive procedure)
-Patients selected should have used NIV previously and should meet none of the NIV exclusion criteria
Hypoxemic respiratory failure as an acute care indication for NIV - Correct answer✅✅ Hypoxemic
respiratory failure (problem oxygenating)
-Clinical trials of NIV to manage acute hypoxemic respiratory failure have yielded conflicting results
-depends on patient
*Acute cardiogenic pulmonary edema as an acute care indication for NIV - Correct answer✅✅ Acute
cardiogenic pulmonary edema (excess fluid in their pulmonary system)
-Is effective, therapy is provided:
--Mask CPAP of 8 to 12 cm H2O and 100% O2 is first-line therapy to treat hypoxemia associated with
severe cardiogenic pulmonary edema
--NPPV should be reserved for those with both hypercapnia and hypoxemia
Pneumonia as an acute care indication for NIV - Correct answer✅✅ -Only improves outcomes for
COPD patients who develop pneumonia
Acute lung injury(ALI) and ARDS as an acute care indication for NIV - Correct answer✅✅ NIV ususally
doesn't support routine use (usually need mech. ventilation):
