non-invasive positive pressure Flashcards
non-invasice positive pressure ventilation
application of positive pressure ventilation without the placement of an artificial airway like : et tube, and tracheotomy tube
purpose for NIV
alternate terminology for non-invasice positive pressure
non-tradional form of NIV
rocking bed, chest cuirass, iron lung
specific disease entities or indication for treatment with NIV
copd, asthma, acute cardiogenic pulmonary edema, hypoxemic respiratory failure, do not intubate order, difficult weaning, hypoventilation syndrome
goal for COPD
reduce Paco2
increase the pao2
work to normalize the PH
avoid intubation
goals for acute cardiogenic pulmonary edema
improve pa02
allow time for medications to work
avoid intubation
community acquire pneumonia goals
reduce the paco2
support oxygenation
avoid intubation
allow time for medications to work
hypoxemic respiratory failure definition and goals
definition : pao2/fio2 greater or equal 300
goals: increase pao2
decreased the paco2
avoid intubation
hypoventilation syndrome
pain/anxiety or atelectasis causing increased RSBI goals: decreased the Paco2 hyperinflation decrease the RR avoid intubation almost replacing Ippb on ward
don no intubate orders
some patient/families have a directive of no intubation the patient is in respiratory failure patient or family wants a save goals: avoid intubation correct Paco2, Pao2, and PH overcome short term respiratory failure
failure to wean from CMV
goal: correct hypercapnea
correct hypoxemia
avoid intubation
potential exclusion criteria
apnea hemodynamics or cardiac instability facial burns/ trauma risk for aspiration copious secretion
nasal mask
mask that just cover nose and triangular shape with soft seal : silicone, soft plastic
head gear to hold the mask which include bridge, may also have a chin strap
full face mask
more common in acute care
nose/mouth coverage
total face mask
fot everything
large mask causes leaks, strap must be tight,patient uncomfortable
if mask fits the minimal leaks
minimal tensionon straps/headgear
hazard of mask related problem
leak low minute ventilatio/tidal volume pressure sores/necrosis nasal/ sinus pain discomfort/claustrophobia
pressure/flow problems
gastric distension eye irritation sinus or ear pain nasal or airway dryness barotrauma
hypoventilation
decreased minute ventilation with changes in patients compliance or resitance
most common ventilation mode
pressure control
pressure is measured and used as feedback signal controlling inspiration
pressure rise to a preset level and is maintained through inspiration
if the patients compliance or resistance changes, pressure remain constant
changes in patients compliance or resistance
decreases tidal volume and minute ventilation
Epap
expiratory positive airway pressure
baseline pressure
IPAP
inspiratory positive airway pressure
pressure delivered during inspiration
trigger
flow trigger
cycling
flow cycled
