Non-invasive ventilation for acute and chronic patients with a variety of conditions
GUIDELINE (2008) - The use of non-invasive ventilation in the management of patients with COPD admitted to hospital with acute type II respiratory failure. BTS/RCP/Intensive Care Society
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/NIV/Guidelines/NIVinCOPDFullguidelineFINAL.pdf
Cochrane report on NIV for weaning (2010):
www.library.nhs.uk/RESPIRATORY/ViewResource.aspx?resID=238714&tabID=289
Angus RM (1996) Comparison of the acute effects on gas exchange of nasal ventilation and doxapram in exacerbations of COPD. Thorax, 51, 1048-50
thorax.bmj.com/cgi/content/abstract/51/10/1048?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=angus&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=51&firstpage=1048&resourcetype=HWCIT
NIV is better than doxapram for exacerbations of COPD
Annane D (1999) Mechanisms underlying effects of nocturnal ventilation on daytime blood gases in neuromuscular disease. Eur Resp J, 13, 157-62
erj.ersjournals.com/cgi/reprint/13/1/157?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=13&firstpage=157&resourcetype=HWCIT
mechanism of NIV may be chemoreceptor adaptation to reduced PaCO2
Antonelli M et al (2001) Predictors of failure on noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure. Int Care Med, 27, 1718-28
springerlink.metapress.com/content/6v6ck1m43tq1qw0h/?p=6292d96fce2c46f88abb93d54aa0a87cπ=5
if there is no improvement within an hour, NIV is likely to fail
Bach JR (2010) Open gastrostomy for noninvasive ventilation users with neuromuscular disease. Am J Phys Med Rehab, 89, 1, 1-6
journals.lww.com/ajpmr/pages/currenttoc.aspx
open gastrostomy without intubation or general anesthesia improves nutrition for ventilator-dependent patients
Baillard C (2006) Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med, 15, 174, 2
ajrccm.atsjournals.org/cgi/content/abstract/174/2/171
Bott J et al (1993) Randomised controlled trial of nasal ventilation in acute ventilatory failure due to COAD. Lancet, 341, 1555-57
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-49KSD50-PM&_user=10&_coverDate=06%2F19%2F1993&_alid=533320006&_rdoc=1&_fmt=summary&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_ct=1&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c69088ee175703288f316048f9001857
NIV in acute ventilatory failure due to COPD causes a significant rise in pH, reduced PaCO2, reduced breathlessness, and reduced mortality.
Burns KEA, Adhikari NKJ, Keenan SP, Meade MO (2010) Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure. Cochrane Database of Systematic Reviews, Issue 8
onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004127/frame.html
NIV shows a consistent, positive effect on mortality and ventilator associated pneumonia
Crummy F, Naughton MT (2007) Non-invasive positive pressure ventilation for acute respiratory failure. Internal Med J, 37, 2, 112118
www.blackwell-synergy.com/doi/abs/10.1111/j.1445-5994.2007.01268.x
indications, contraindications and guidelines
Denehy L, Berney S (2001) The use of positive pressure devices by physiotherapists. Eur Respir J, 17, 821-9.
erj.ersjournals.com/cgi/content/full/17/4/821?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1135616719995_820&FIRSTINDEX=0&sortspec=relevance&volume=17&firstpage=821&resourcetype=1&journalcode=erj
excellent overview of CPAP, IPPB and NIV
Diaz O, Begin P, Torrealba B et al (2002), Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD. Eur Respir J, 20, 14908
www.erj.ersjournals.com/cgi/content/full/20/6/1490
NIV for severe stable hypercapnic COPD patients improves daytime blood-gases and reduces pulmonary hyperinflation and inspiratory loads.
Di Marco F, Centanni S, Bellone A (2011) Optimization of ventilator setting by flow and pressure waveforms analysis during noninvasive ventilation for acute exacerbations of COPD: a multicentric randomized controlled trial. Crit Care, 15, R283 doi:10.1186/cc10567
ccforum.com/content/15/6/r283/abstract
Domιnech-Clar R (2003) Home mechanical ventilation for restrictive thoracic diseases: effects on patient quality-of-life and hospitalizations. Respir Med, 97, 1320-1327
home NIV improves quality of life and reduced hospitalisation
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WWS-49R5FXR-1&_user=10&_handle=V-WA-A-W-AB-MsSAYVA-UUA-U-AAWAUUYVBZ-AAAYCYEWBZ-AZVAVCWVY-AB-U&_fmt=summary&_coverDate=12%2F31%2F2003&_rdoc=13&_orig=browse&_srch=%23toc%237138%232003%23999029987%23469419!&_cdi=7138&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=5a20ae97539698a879458cb23b5ed8e7
Domιnech-Clar R (2009) Adaptation and follow-up to noninvasive home mechanical ventilation: Ambulatory versus hospital. Respir Med, 102, 11, 1521-1527
cel.isiknowledge.com/full_record.do?product=CEL&colname=CEL&search_mode=CitingArticles&qid=4&SID=T2M6aAjdI4OLh9CJjfm&page=1&doc=10
improved arterial blood gases and quality of life in patients with restrictive ventilatory disorders
Ferrer M (2009) Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial. Lancet, 374, 9695, 1082-9
early NIV after extubation reduces mortality in hypercapnic weaning COPD patients
Gay PC (2009) Complications of noninvasive ventilation in acute care. Respir Care,
54, 2, 246-57
Granton JT et al (2002) Noninvasive nocturnal ventilatory support in advanced lung disease from cystic fibrosis. Respir Care, 47, 6, 675-81
NIV is well-tolerated and improves symptoms
Hilbert G et al (2002) Noninvasive ventilation in acute exacerbations of COPD. Crit Care Med, 30, 1453-8
www.ccmjournal.com/pt/re/ccm/abstract.00003246-200207000-00009.htm;jsessionid=FC1B2F0TM1NyjmRTpfF3z1vW4B0nS1mGxv0QkkpnCQdhjX8ptJ5D!1416047858!-949856144!8091!-1?index=1&database=ppvovft&results=1&count=10&searchid=2&nav=search
length of ICU stay is reduced in COPD patients with exacerbations if they are on NIV at home
Hoffmann B, Welte T (1999) The use of noninvasive pressure support ventilation for severe pulmonary oedema. Int Care Med, 25, 15-20
springerlink.metapress.com/content/f9r722p8qt82pbme/?p=310b3940bd6e403e9cf7ff19c1ebee73π=5
NIV helps patients with severe pulmonary oedema at risk of intubation
Janssens JP (1998) Transcutaneous PCO2 to monitor noninvasive mechanical ventilation. Chest, 113, 768-73
www.chestjournal.org/cgi/reprint/113/3/768?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=113&firstpage=768&resourcetype=HWCIT
transcutaneous monitoring is a noninvasive alternative to arterial blood gases
Madden BP (2002) Noninvasive ventilation in cystic fibrosis patients with acute or chronic respiratory failure. Eur Respir J, 19, 310-13
erj.ersjournals.com/cgi/content/full/19/2/310?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=19&firstpage=310&resourcetype=HWCIT
NIV useful for acute patients and may prolong life in chronic patients
Nava S (2004) Causes of failure of noninvasive mechanical ventilation. Respir Care, 49, 295-303
www.rcjournal.com/contents/03.04/03.04.0295.pdf
Nugent AM et al (2002) Domiciliary-assisted ventilation in patients with myotonic dystrophy. Chest, 121, 459-64
www.chestjournal.org/cgi/content/full/121/2/459?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Nugent+AM+&andorexactfulltext=and&searchid=1128073039273_1224&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=121&firstpage=459&resourcetype=1&journalcode=chest
home NIV prolongs survival and improves blood gases.
Pasquina P, Merlani P (2004) Continuous Positive Airway Pressure versus noninvasive pressure support ventilation to treat atelectasis after cardiac surgery. Anesth Analg, 99, 10018
www.anesthesia-analgesia.org/cgi/content/abstract/99/4/1001?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Pasquina+&searchid=1135624807190_746&FIRSTINDEX=0&sortspec=relevance&volume=99&firstpage=1001+&journalcode=anesthanalg
neither adjunct very helpful for post-op atelectasis, but NIV is preferable.
Plant PK (2000) Early use of non-invasive ventilation for acute exacerbations of COPD on general respiratory wards. Lancet, 355, 1931-5
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-40KY06X-18&_user=10&_coverDate=06%2F03%2F2000&_alid=533319620&_rdoc=1&_fmt=summary&_orig=search&_cdi=4886&_sort=d&_docanchor=&view=c&_ct=1&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=35ec83d1fcf3ae815d82a56d2b4d3eb9
early use of NIV for mildly and moderately acidotic COPD leads to more rapid improvement, reduction in IPPV, and reduction in in-hospital mortality. .
Plant PK, Owen JL, Elliott MW (2002) Non-invasive ventilation in acute exacerbations of COPD. Thorax, 56, 708-12
thorax.bmj.com/cgi/content/full/56/9/708?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=56&firstpage=708&resourcetype=HWCIT
noninvasive ventilation can prevent intubation
Polese G, Vitacca M, Bianchi L et al (2000) Nasal proportional assist ventilation unloads the inspiratory muscles of stable patients with hypercapnia due to COPD. Eur Respir J, 16, 491-8
erj.ersjournals.com/cgi/content/abstract/16/3/491?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Vitacca&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
Polkey MI (1999) Ethical and clinical issues in the use of home NIV for the palliation of breathlessness in motor neurone disease. Thorax, 54, 367-71
thorax.bmjjournals.com/cgi/content/full/54/4/367?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Polkey+&andorexactfulltext=and&searchid=1128073142735_531&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=54&firstpage=367&resourcetype=1&journalcode=thoraxjnl
identification and palliation of respiratory muscle weakness and ventilatory failure, including non-invasive ventilation
Porta R, Vitacca M, Clini E (1999) Physiological effects of posture on mask ventilation in awake stable chronic hypercapnic COPD patients. Eur Respir J, 14, 517-22
erj.ersjournals.com/cgi/content/abstract/14/3/517?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Vitacca&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
patients can take up whichever position they prefer because this will not affect the NIV
Scala R, Naldi M, Archinucci I et al (2004) Non-invasive positive pressure ventilation in COPD patients with acute hypercapnic respiratory failure and altered level of consciousness. Eur Respir J, 24: Suppl.48, 475s
www.ersnet.org/ers/lr/browse/media.aspx?id_dossier=17393&id_fiche=122387
severe impairment of consciousness may lead to failure
Schφnhofer B, Geibel M, Sonneborn M (1997) Daytime mechanical ventilation in chronic respiratory insufficiency. Eur Resp J, 10, 2840-6
erj.ersjournals.com/cgi/reprint/10/12/2840?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=10&firstpage=2840&resourcetype=HWCIT
daytime NIV is effective for patients who prefer this to night NIV
Tzeng AC, Bach JR (2000) Prevention of pulmonary morbidity for patients with neuromuscular disease. Chest, 118, 1390-1396
www.chestjournal.org/cgi/content/full/118/5/1390?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=118&firstpage=1390&resourcetype=HWCIT
protocol for home NIV for neurological patients
Vanpee D et al (2002) Does inspiratory behaviour affect the efficiency of non-invasive ventilation in COPD patients? Respir Med, 96, 709-15
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WWS-46G484J-9&_user=10&_coverDate=09%2F30%2F2002&_alid=533326338&_rdoc=1&_fmt=summary&_orig=search&_cdi=7138&_sort=d&_docanchor=&view=c&_ct=1&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=07cd7f49ccc97ad99eff1b41250d5fa1
relaxed breathing pattern is beneficial when using NIV
BTS = British Thoracic Society
CPAP = continuous positive airways pressure
Doxapram = respiratory stimulant drug
IPPB = intermittent positive pressure breathing
IPPV = intermittent positive pressure ventilation
NIPPV = non-invasive positive pressure ventilation (i.e. NIV)
NIV = non-invasive ventilation
RCP = Royal College of Physicians