17. Non Invasive Ventilation

Question 1

1. Indications

Answer 1

1. Treatment of hypoxemic resp failure
   type 1
   - pneumonia / immunocomp / pot pneumonectomy
2. Rx acute hypercapnic resp failure (t2)
   - secondary to copd exacerb
   mild to mod acidosis
3. Aid weaning invasive ventilation
4. Post Extubation or tace decan
   - lower re intubation with early intro
5. Cardiogenic Pulmonary Oedema
6. Useful when intubation is contraindicated
   refusal / palliation
7. Asthma
8. NM disease
   GBS/Muscular dystrophy

Question 2

Contraindications

Answer 2

Need for immediate intubation due to woresning organ dysfunction
-worsening respiratory function
or non resp fail (HD instab / GIB / Encephalpathy

Cardiorespiratory arrest

Facial / upper airway trauma

GCS<8 - loss airway patency

Excessiev airway secretions

Lack coop
high aspiration riskk

Question 3

Benefits NIV

Answer 3

1. Improves alveolar ventilation & WOB
2. Reduce morbidity and mortality
   intubation rates
   Rx failure rates
3. Acoids side oeffect of ETT
   trauma mucosa / teeth
   trachel stenosis
   altered HD - pressor response
4. Patients meanaged wards / intermed / areas
5. Can avoid need for sedation to tolerate tube

Question 4

Complications NIV

Answer 4

Local damage secondary to apparatus
Bridge nose / forehead / scalp

Gastric diltation

Ocular irritation / sinus congestion

Compliance
discomfort

inabil communicate / eat / drink

May worse secretion clearance
Increase risk infection / worsening resp failure