Title: Non-Invasive Positive Pressure Ventilation<br/>Author: Feras Khan<br/><a href='http://umem.org/profiles/faculty/1145/'>[Click to email author]</a><hr/><ul> <li> A recent meta-analysis found that non-invasive ventilation can improve survival in acute care settings.</li> <li> Consider using NIPPV in: <ul> <li> COPD exacerbation</li> <li> Obesity hypoventilation syndrome</li> <li> Asthma</li> <li> Hypoxemic respiratory failure</li> <li> Cardiogenic pulmonary edema</li> <li> ARDS</li> </ul> </li> <li> Make sure to reassess your patients for improvement within one hour of applying NIPPV. If gas exchange has not significantly improved then endotracheal intubation and mechanical ventilation should be considered.</li> <li> Adverse effects: <ul> <li> Gastric distension</li> <li> Pressure ulcers on the face</li> <li> Can be uncomfortable</li> </ul> </li> <li> In cardiogenic pulmonary edema there are cardiac performance benefits: <ul> <li> Decreases preload</li> <li> Decreases left ventricular afterload</li> <li> Improved cardiac ouput</li> </ul> </li> </ul> <fieldset><legend>References</legend>
<p> Cabrini L et al. Noninvasive ventilation and survival in acute care settings: a comprehensive systematic review and metaanalysis of randomized controlled trials. Crit Care Med 2015; 43:880-888. </p> </fieldset>