ABSTRACT
Several studies have shown that non-invasive mechanical ventilation (NIV) represents an effective treatment for acute respiratory failure. This technique has been applied in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD), cardiogenic pulmonary oedema and hypoxaemic respiratory failure due to various causes.1-17 In addition, NIV has been also used in post-extubation respiratory failure and as a weaning tool mainly in patients with COPD.18-23 Monitoring is essential to evaluate the efficacy of NIV and to identify patients who will fail on this technique. During the first few hours of NIV monitoring is mainly performed by a conti nuous evaluation of the patient’s clinical status and arterial blood gases to assess the initial response to this treatment.1,6,7,15,16,24-28 More advanced monitoring is important in order to optimize the efficacy of therapy. This should include monitoring of air leakage, patient-ventilator asynchrony and sleep quality. Box 11.1 summarizes the monitoring requirements during NIV.
