NIV/NIPPV Flashcards

1
Q

Benefits of NIV

A
reduces need for intubation
reduces hospital/ICU stay
reduces nosocomial pneumonia
reduces mortality
preserves pts airway defenses
improves comfort
useful for pre-oxygenation

chronic:
helps with sleep apnea

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2
Q

What is CPAP

A

continuous positive airway pressure

provides same pressure for full resp cycle

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3
Q

Can all non-invasive and invasive deliver CPAP?

A

Yes

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4
Q

Does trapped gas from high-flow act as a CPAP?

If so, at what pressure and what does it improve?

A

2-5 cmH2O

improves oxygenation

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5
Q

What will happen to the CPAP in the lungs if we increase set flow OR pt closes his mouth?

A

CPAP will increase in the lungs

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6
Q

What does BiPAP stand for?

A

Bi-level positive airway pressure

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7
Q

What control mode can NIPPV be used on?

P/C, V/C or both?

A

Both

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8
Q

Primary goal of NIPPV acute and chronic

A

acute:
prevent intubation by improving gas exchange. reducing nosocomial infection, vap, airway trauma, patient discomfort
Improving alveolar minute ventilation = reduce CO2
chronic:
improve pt’s quality of life and reduce hypoventilation

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9
Q

Acute indications for NIPPV

A
Hypercapnic RF
COPD exacerbation
acute cardiogenic PE
asthma
post extubation RF
post op RF
faciliate extubation for COPDers
hypoxemic RF (cautiously)
RF in immunocompromised pts
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10
Q

Chronic indications for NIPPV

A
Nocturna; hypoventilaion
ALS (amyotrophic lateral sclerosis)
Restrictive thoracic diseases
COPD
OHS (obesity hypoventilation syndrome)
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11
Q

What does SVN stand for?

A

small volume nebulizer

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12
Q

What does DPI stand for?

A

dry powdered inhaler

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13
Q

What does MDI stand for?

A

metered dose inhaler

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14
Q

Can pts receive antibiotics, bronchodilators and ICS through the aerosol route?

A

Yes

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15
Q

What mask should be used if using a critical care ventilator for NIPPV?

A

Non-vented mask

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16
Q

What mask should be used if using a non-invasive ventilator for NIPPV?

A

Vented mask

17
Q

How would you increase the flow through the exhalation port and minimize CO2 re-breathing?

A

Increase the EPAP

18
Q

What are two risks of using HME with NIPPV?

A

Increase resistance & WOB

19
Q

What are two benefits of using HME with NIPPV?

A

Costs & simplicity

20
Q

What are complications of NIPPV via nasal mask?

A

nasal dryness, congestion, resistance, dry mouth

21
Q

How much water does our respiratory tract evaporate everyday?

A

400 grams H2O

22
Q

How to catch a tachypneic pt with NIPPV

A

RR >30 bpm

Ineffective tidal volume

23
Q

How to predict success when using NIPPV

A
Improvement of gas exchange
decrease PaCO2
normal pH
increase PaO2 and SpO2
Increased Vt
relaxes muscles
normal HR
within 1-2 hours
24
Q

How to predict failure when using NIPPV

A

No improvement in pH, PaO2 and PaCO2
continued or increased respiratory distress
Worse LOC
= intubation should be considered especially if hypoxemic
Inability to clear secretions

25
Q

Name two critical complications of NIPPV

A

Aspiration & Pneumothorax