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Table 113.2

Checklist for Set-Up of NIV (Bi-Level NIV)

  • Explain the treatment to the patient.
  • Use a well-fitting full-face mask (sized to the patient, small, medium or large).
  • Start at low pressures tolerated by most patients:
    • IPAP of 10 cm H2O
    • EPAP of 4 cm H2O
  • Other settings at default levels.
  • Allow the patient to hold the mask over their face without the straps tightened.
  • Tighten the straps to form a seal around the face, but not so tight as to squash the membranes of the mask.
  • Increase the IPAP in increments of 2–5 cm H2O approximately 5 cm H2O every 10 min to a target IPAP of 20 cm H2O or to the maximum tolerated by the patient. In general, an EPAP of 4–8 cm H2O should be adequate for patients with exacerbation of COPD; EPAP >10 cm H2O is poorly tolerated.