The practical guide for NIV..part 2

How non-invasive ventilation (NIV) works

-Improves laminar flow of air- stents open smaller airways
-This decreases atelectasis which improves pulmonary compliance and decreases the patient’s work of breathing
-For pulmonary edema- does not “blow the fluid out of the lungs”
-Increases intrathoracic pressure -> decreases venous return
-Decreases preload and afterload

When to use NIV
-Any patient with respiratory distress who is not responding to
simple interventions , like in exacerbation of COPD, Asthma, CHF, Pulmonary edema,
-Can also use NIV to pre-oxygenate prior to intubation
-Don’t need to figure out the diagnosis before you start NIVshoot
first and ask questions later- use it early and often
-Least evidence for use in asthma
-Can also use for patients with DNR/DNI to relieve air hunger
and/or buy time to address resuscitation status

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