ABSTRACT
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.
