Non-invasive ventilation (NIV)

Abstract

Non-invasive positive pressure ventilation (NiPPV) is an effective form of ventilatory assistance. It was first used at the beginning of the twentieth century; since then, there has been growing interest in its role in treating type 2 (hypercapnic) respiratory failure. In the last 20 years NiPPV has had an important role in the management of acute exacerbations of chronic obstructive pulmonary disease (COPD), but its use is not limited to those with COPD. Initially, NiPPV was used mainly to support patients with neuromuscular disease, poliomyelitis, and pulmonary oedema. Since then many different groups of patients have been found to benefit from NiPPV, including patients requiring bridging pre-transplant, post-surgical respiratory support, and weaning from mechanical ventilation. NiPPV is also increasingly used to support patients with spinal injury. This chapter describes types 1 and 2 of chronic respiratory failure, types of ventilators and interfaces, and the British Thoracic Society indications for use and contraindications are all covered. Nursing care considerations and service provision are both included.