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Non-Invasive Ventilation in Acute Respiratory Failure

Emergency indications and technique of non-invasive mechanical ventilation

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göğüs Hastalıkları department. Book Appointment →

What is Non-Invasive Ventilation in Acute Respiratory Failure?

Non-invasive ventilation (NIV) provides positive pressure ventilation through a face mask without endotracheal intubation. It carries class I indications in COPD exacerbation and acute cardiogenic pulmonary oedema.

BiPAP (with separate IPAP/EPAP) and CPAP are the most commonly used modes. NIV reduces the need for intubation and invasive mechanical ventilation, ICU length of stay and mortality, but proper patient selection and close monitoring are critical.

Symptoms

Acute dyspnoea and tachypnoea
Use of accessory respiratory muscles
Hypercapnia (PaCO2 >45 mmHg) and respiratory acidosis
Hypoxaemia (PaO2/FiO2 <300)
pH 7.25-7.35 in COPD exacerbation

Risk Factors

COPD exacerbation (hypercapnic respiratory failure)
Acute cardiogenic pulmonary oedema
Respiratory failure in immunosuppressed patients
Post-extubation respiratory failure
Patients with do-not-intubate orders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • COPD exacerbation with pH <7.35 and PaCO2 >45 mmHg
  • Acute pulmonary oedema unresponsive to oxygen therapy
  • Respiratory rate >25/min with accessory muscle use
  • Lack of improvement on NIV within 1-2 hours warrants intubation evaluation

Treatment Methods

01
BiPAP starting settings: IPAP 10-12 cmH2O, EPAP 4-5 cmH2O
02
CPAP (8-10 cmH2O) in cardiogenic pulmonary oedema
03
Selection of an appropriate mask (oronasal or total face)
04
Arterial blood gas check after one hour
05
Failure criteria: worsening pH, haemodynamic instability, deteriorating consciousness
06
Preparation for intubation should not be delayed when NIV fails

Which Department to Visit?

You can visit our Göğüs Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göğüs Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.