chapter  7
18 Pages

Starting non-invasive ventilation: Practical aspects A K Simonds

Goals of non-invasive ventilation 82

Initial ventilator settings: bilevel non-invasive ventilation 87

Monitoring and assessment of progress 90

Humidification 91

Duration of non-invasive ventilation 91

Tolerance of non-invasive ventilation 91

Swapping to a different ventilator 91

Non-invasive ventilation failure 92

Common practical problems 93

Sedation: risks and options 94

Patients with a tracheostomy or endotracheal tube 95

Long-term management 95

Further reading 96

References 96

The following is a guide to starting non-invasive positive pressure ventilation (NIV). There are no absolute recipes for success, but the key to a favourable outcome lies in the selection of appropriate patients, the availability of suitable equipment, familiarity with the technique and adequate staffing levels. A team approach with a continuing NIV education programme for all members is likely to improve results. As well as selection of appropriate patients for NIV, operators need to be able to recognize NIV failure and have a plan of action for those circumstances.