It’s no exaggeration to say that NIV has revolutionized the treatment of acute respiratory failure.4 And recently, high-flow nasal cannula (HFNC) oxygen delivery has gained popularity as part of a strategy for supportive therapy in many clinical situations, including weaning.
Learn what experts are saying about these modalities.
Clinicians understand that while invasive ventilation can be lifesaving, the risk of potential complications – like infections and injury to the lungs and other organs – runs high. That’s why NIV has become a widely used therapy option and is now considered the mode of choice for some conditions.
NIV has also been associated with reduced length of hospital stay and reduces mortality, patient discomfort and length of-stay for exacerbations of COPD compared to standard therapy.5
Application
Minimize ventilator acquired pneumonia6
Decreases work of breathing
Oral patency
Here are some tips:
Set realistic expectations – NIV does not avoid intubation in all cases – a NIV failure rate of 20-40% is expected based on current clinical evidence.7
Experience matters – Only practice of NIV will lead to the needed experience to perform successful NIV.
Noninvasive ventilation is one of those rare medical technologies that both improves patient outcomes and reduces treatment costs.”
– Adam Seiver, MD, PhD, MBA, chief medical officer, Philips Monitoring and Analytics & Therapeutic Care
| Complication | Remedy8 |
| Nasal congestion | Try humidification or speak to the physician for various remedies to assist with this problem |
| Nasal or oral dryness | Add humidification, nasal saline, oral/nasal hygiene, or decrease leak |
| Sinus or ear pain | Lower inspiratory pressure |
| Gastric inflation | Avoid excessive inspiratory pressures (over 20 cmH2O) |
| Eye irritation | Check mask fit, readjust bottom headgear straps, and be aware of air leaks near eyes |
| Failure to ventilate | Use sufficient pressures, optimize patient-ventilator synchrony |
| Complication | Remedy8 |
| Discomfort | Check fit, adjust straps, or change the mask |
| Nasal or oral dryness | Add humidification, nasal saline, oral/nasal hygiene and manage leak by decreasing the amount of leak |
| Nasal bridge redness or ulceration | Use an artificial skin, minimize strap tension, use LiquiCell, alternate masks or use a PerforMax or Total face mask |
| Skin irritation or rashes | Use a skin barrier lotion and/or topical corticosteroids, change to a mask made from a different material, be sure to properly clean the mask |
| Claustrophobic reactions | Try a nasal mask or |
Philips hospital ventilators are designed to help you respond quickly to changing patient conditions, across the continuum, while delivering consistent quality care.
Length of therapy, the type of delivery device, safety features and the patient’s facial features are all factors to consider when selecting a mask. Philips respiratory masks and interfaces offer a range of options to help you make quick therapy transitions.
Explore webinars, courses and videos for practice guidelines and ways to enhance your hospital ventilation program’s success.
Skin integrity training
LeBonheur Children’s Hospital and Philips team up to bolster staff education through Philips Saving Face NIV mask rotation training program.
HFNC and NIV current and practice
This presentation reviews evidence in support of NIV and discusses the research evaluating HFNC and its role in the management of respiratory failure.
Optimal respiratory care requires optimal technique
High-flow oxygen therapy (HFT), noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV): Understanding which technique is appropriate and when, can help improve patient care and assist clinical teams for success.
References
1. According to the American Association for the Surgery of Trauma (AAST).
2. Mehta AB, Syeda SN, Wiener RS, Walkey AJ. Epidemiological trends in invasive mechanical ventilation in the United States: a population-based study. J Crit Care. 2015;30(6): 1217-1221.
3. McConville JF, Kress JP. Weaning patients from the ventilator. N Engl J Med. 2012;367(23):2233-2239.
4. Scott K. Epstein, MD, Respiratory Care, January 2009 Vol 54 No 1.
5. Keenan SP, Gregor J, Sibbald WJ, Cook D, Gafni A. Noninvasive positive pressure ventilation in the setting of severe, acute exacerbations of chronic obstructive pulmonary disease: more effective and less expensive. Crit Care Med. 2000 Jun;28(6): 2094-102.
6. Respiratory Care, Feb 2009 54(2):198-211)
7. Hess D. How to Initiate a Noninvasive Ventilation Program: Bringing the Evidence to the Bedside. Respiratory Care (2009), Vol 54 NO 2: p. 232-245.
8. Nava, S., et al. Interfaces and Humidification for Noninvasive Mechanical Ventilation. Resp. Care. Jan 2009. Vol 54-1.
9. Squadrone E, et al. Noninvasive vs invasive ventilation in COPD patients with severe acute respiratory failure deemed to require ventilatory assistance. Inten Care Med. 2004;30(7).
Philips is not a medical care provider, and this information is not intended to diagnose, examine treat or manage medical conditions of any kind. The content on this page is not a substitute for professional judgment by a healthcare provider.
