Non invasive Ventilation - Essay Example

Non-invasive ventilation Introduction Non-invasive ventilation, abbreviated NIV, is the administration of ventilatory support to the lungs without the use of an invasive artificial airway (tracheostomy tube or endotracheal tube) (Soo Hoo, 2010). It can either be non-invasive positive pressure ventilation, abbreviated NPPV, which refers to ventilation with positive airway pressure and without tracheal tube; or negative pressure ventilation, referring to ventilation in which negative pressure is applied to the thorax (Jones, 2009).

Soo Hoo (2010) explains that NIV has now become an essential tool in managing chronic and acute respiratory failure, in critical care unit and in the home setting. One reason as to why the use non-invasive ventilation has been on the increase is the desire to prevent invasive ventilation’s complications. Although highly reliable and effective in sustaining alveolar ventilation, the complications risks of endotracheal intubation/invasive mechanical ventilation are renowned. The advantages of non-invasive ventilation include the fact that it permits patients to expectorate secretions, to verbalize, to drink and to eat; it leaves the upper airway unharmed; and safeguards airway defense mechanisms.

NPPV decreases infectious mechanical ventilation’s complications and compared to endotracheal intubation, it may enhance portability, convenience, and comfort at a cost no greater or even lower. In addition, it may be possible to administer NIV outside of the setting of intensive care, thereby permitting caregivers to make use of acute-care beds more rationally. NPPV also makes chronic respiratory failure patients’ care in the home much simpler (Mehta and Hill, 2001). Others include improved patient comfort, early ventilatory support, reduced sedation requirements, patient can cooperate with physiotherapy, among others.

NIV also has its disadvantages, which include the fact that there is no direct access to bronchial tree for aspiration, it is time consuming for nursing and medical staff, the airway is not protected, and the mask is claustrophobic/uncomfortable, among others (AnaesthesiaUK, 2010). Conclusion Presently, the use of NIV has become commonplace. In acute exacerbation of COPD, it is regarded as the ventilator mode of first choice. Alone, Continuous Positive Airway Pressure (CPAP) is very efficient for the treatment of acute pulmonary oedema.

Doctors are using NIV to aid weaning from invasive ventilation. Moreover, in hypoxaemic respiratory failure, NIV decreases the chances of endotracheal intubation. In patients with chest wall deformity and neuromuscular diseases, NIV is also first choice. Other acceptable indications include obstructive sleep apnoea patients not responding to CPAP as well as those of central hypoventilation (AnaesthesiaUK, 2010). It is important to note that the key to apply NIV effectively lies in recognizing its limitations as well as capabilities.

This also calls for careful patient selection and assessment in order to establish whether he/she qualifies for NIV (Soo Hoo, 2010). References AnaesthesiaUK. (2010). Non-invasive ventilation. Retrieved from http://www.frca.co.uk/article.aspx?articleid=100430 (accessed March 21, 2011). Jones, A, (2009). Non-invasive Ventilation. Retrieved from http://www.respiratorycare-online.com/2010_sd/NIV/NIV_handout.pdf Mehta, S. & Hill, N. S. (2001). Non-invasive Ventilation. American Journal of Respiratory and Critical Care Medicine 163(2), 540-577.

Soo Hoo, G. W. (2010). Ventilation, Non-invasive. Retrieved from http://emedicine.medscape.com/article/304235-overview