How does NIV machine work?

How does NIV machine work?

NIV works by creating a positive airway pressure – the pressure outside the lungs being greater than the pressure inside of the lungs. This causes air to be forced into the lungs (down the pressure gradient), lessening the respiratory effort and reducing the work of breathing.

Is NIV and CPAP the same?

While there are similarities with regard to the interface, NIV is not the same as continuous positive airway pressure (CPAP), which applies a single level of positive airway pressure throughout the whole respiratory cycle; CPAP does not deliver ventilation but is occasionally used in conditions also treated with NIV.

What is difference between NIV and ventilator?

In invasive ventilation, air is delivered via a tube that is inserted into the windpipe through the mouth or sometimes the nose. In NIV, air is delivered through a sealed mask that can be placed over the mouth, nose or the whole face.

What are the contraindications for NIV?

Absolute contraindications for NIV are as follows:

  • Respiratory arrest or unstable cardiorespiratory status.
  • Uncooperative patients.
  • Inability to protect airway (impaired swallowing and cough)
  • Trauma or burns involving the face.
  • Facial, esophageal, or gastric surgery.
  • Apnea (poor respiratory drive)
  • Reduced consciousness.

What is EPAP and IPAP?

Non-Invasive Positive Airway Pressure Treatment Two levels of pressure are then delivered to the patient – a lower pressure during expiration (EPAP) and a higher pressure delivered during inspiration (inspiratory positive airway pressure; IPAP).

What is the difference between NIV and HFNC?

HFNC can provide continuous oxygen up to 70L/min via nasal prongs with the potential advantage of remaining in place for apneic oxygenation. NIV can also provide high flow oxygen but must be removed during the apneic phase of intubation.

Why does BP drop with NIV?

The blood pressure reduction observed under NIV could be explained by increased airway and intrathoracic pressure leading to increased lung volume and subsequent decreases in transmural left ventricular pressure and afterload 36.

How do you increase oxygen in the NIV?


  1. patient reassurance.
  2. well fitted mask with straps (nasal, full face or helmet)
  3. set appropriate FiO2.
  4. time or flow cycled.
  5. start at low pressures e.g. 10/5 cmH2O or CPAP 5 cmH20.
  6. increase pressures by 2-3 cmH20 every 5 minutes until satisfactory response (up to 15-17 max)
  7. reassess after 60 minutes plus ABG.

What is PS on BiPAP?

That difference, the difference between expiratory positive airways pressure and inspiratory positive airways pressure is called pressure support. So in PAP terms, that would be called PS, pressure support, so a minimum pressure support of three.

Is IPAP same as PEEP?

1): Inspiratory positive airway pressure (IPAP): pressure delivered by the ventilator while the patient is inhaling. Expiratory positive airway pressure (EPAP): pressure delivered by the ventilator while the patient is exhaling. EPAP is equivalent to PEEP (positive end-expiratory pressure).

Is NIV better than oxygen?

To date, few randomized controlled studies have found better outcomes with NIV than with standard oxygen (35,36). The heterogeneity of patients included in studies comparing NIV to standard oxygen, i.e., patients with hypercapnia or cardiogenic pulmonary edema, may explain high intubation rate variability (7,35-38).

What is the difference between BiPAP and high flow oxygen?

BiPAP has some important advantages compared to HFNC: Positive pressure reduces pre-load and after-load on the heart, improving heart failure (this works similar to an ACE-inhibitor – but easier to titrate and no nephrotoxicity). BiPAP can provide a greater amount of mechanical support for breathing.

What is PIP in NIV?

Similarly, inspiratory pressure may be called positive inspiratory pressure (PIP) or inspiratory positive airway pressure (IPAP). The difference between IPAP and EPAP is PS, which corresponds to the pressure delivered by the ventilator at each insufflation.

How do you reverse co2 retention?


  1. Ventilation. There are two types of ventilation used for hypercapnia:
  2. Medication. Certain medications can assist breathing, such as:
  3. Oxygen therapy. People who undergo oxygen therapy regularly use a device to deliver oxygen to the lungs.
  4. Lifestyle changes.
  5. Surgery.

What is BiPAP IPAP and EPAP?

BiPAP, as the bilevel name suggests, delivers two different pressures, inspiratory positive airway pressure (IPAP) and a lower, expiratory positive airway pressure (EPAP). This allows a higher pressure to be delivered during inspiration, and a lower pressure during expiration, thereby reducing the work of exhaling.

What is non-invasive ventilation?

3. Non-invasive ventilation “The delivery of mechanical ventilation to the lungs using techniques that do not require endotracheal intubation” 4. Background • Initially used in the treatment of hypoventilation with Neuromuscular Disease • Now accepted modality in treatment of acute respiratory failure

What is the importance of close monitoring in non-invasive ventilation?

Close monitoring and serial blood gases are imperative for any patient being treated with non-invasive ventilation so any improvements or deteriorations in the clinical state can quickly be identified.

What are the advantages of noninvasiveness?

Advantages Noninvasiveness • Application – easy to implement or remove • Improves patient comfort • Reduces the need for sedation • Oral patency (preserves speech, swallowing, and cough) 9.

What is the role of CPAP in invasive ventilation?

An escalating pressure requirement may be an indication that invasive ventilation is needed. The aim of CPAP is to splint open airways, reducing alveolar collapse, enable alveolar recruitment and to increase the functional residual capacity to help reduce the work of breathing.