Non-Invasive Ventilation in Acute Respiratory Failure

Non-Invasive Ventilation in Acute Respiratory Failure

Mode of ventilation	Indications	Contraindications	Disadvantages and complications
Continuous positive airway pressure (CPAP)	Cardiogenic pulmonary oedema	Recent facial, upper airway, or upper gastrointestinal surgery Vomiting or bowel obstruction Unconscious or uncooperative patient Copious secretions (relative) Haemodynamic instability Undrained pneumothorax	Patient must be conscious and cooperative Discomfort from tightly fitting facemask Bloating due to aerophagia May fail
Bilevel positive airway pressure (BiPAP)	Acidotic type 2 respiratory failure in acute exacerbation of COPD Acidotic type 2 respiratory failure in patient with chest wall deformity
Remember: Before commencing non-invasive ventilation, an action plan needs to be in place in the event of failure, that is, whether this is ceiling of treatment or whether invasive ventilation should follow.

Mode of ventilation

Indications

Contraindications

Disadvantages and complications

Continuous positive airway pressure (CPAP)

Cardiogenic pulmonary oedema

Recent facial, upper airway, or upper gastrointestinal surgery

Vomiting or bowel obstruction

Unconscious or uncooperative patient

Copious secretions (relative)

Haemodynamic instability

Undrained pneumothorax

Patient must be conscious and cooperative

Discomfort from tightly fitting facemask

Bloating due to aerophagia

May fail

Bilevel positive airway pressure (BiPAP)

Acidotic type 2 respiratory failure in acute exacerbation of COPD

Acidotic type 2 respiratory failure in patient with chest wall deformity

Remember:

Before commencing non-invasive ventilation, an action plan needs to be in place in the event of failure, that is, whether this is ceiling of treatment or whether invasive ventilation should follow.

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Table 11.4