Ventilation Review

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While the critical care ventilators had more options, they were also less tolerant of leaks. The specialty ventilators had fewer options and range, but they were more leak tolerant. In its simplest terms, noninvasive ventilation differs from invasive ventilation by the interface between the patient and the ventilator. Invasive ventilatory support is provided via either an endotracheal tube or tracheostomy tube. Noninvasive ventilatory support uses a variety of interfaces, and these have continued to evolve with modifications based on patient comfort and efficacy. Many of the interfaces or masks were initially used in patients with obstructive sleep apnea before they were adapted for use in patients to provide noninvasive ventilatory support.

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Serial arterial blood gas measurements are essential to monitor the response to therapy and to guide further adjustments in the ventilator. The following provides some guidance on titration of ventilator settings in patients with respiratory distress and who have never been placed on noninvasive ventilation.

This is particularly true in fragile elderly patients who are at higher risk of haemorrhagic complications. Noninvasive ventilation refers to the administration of ventilatory support without using an invasive artificial airway . Noninvasive ventilation has been used as a replacement for invasive ventilation, and its flexibility also allows it to be a valuable complement in patient management. Its use in acute respiratory failure is well accepted and widespread. The role of noninvasive ventilation in those with chronic respiratory failure is not as clear and remains to be defined. Asthma is a respiratory obstructive disease characterised by reversible airway obstruction. During an asthma attack NPPV is applied together with pharmacological therapy in order to reduce respiratory muscle work, thus improving ventilation and avoiding intubation.

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