Respiratory Care in Non Invasive Mechanical Ventilatory Support: Principles and Practices

Contents
Preface
Chapter 1
Respiratory Muscular Function and Anatomy. Implications for Respiratory Care
Abstract
Introduction
Respiratory Muscles
Process of Inspiration
Process of Active Inspiration
Process of Passive Expiration
Process of Active Expiration
Anatomy of Respiratory Muscles
Diaphragm
External Intercostal Muscles
Scalene muscle
Anterior Scalene Muscle
Middle Scalene Muscle
Posterior Scalene Muscle
Sternocleidomastoid
Pectoralis Major Muscle
Pectoralis Minor Muscle
Serratus Anterior
Latissimus Dorsi
Rectus Abdominis Muscle
Internal Intercostal Muscles
Innervation of Respiratory Muscles
Respiratory Muscles in Stress
References
Chapter 2
Gas Exchange During Non-Invasive Ventilation
Abstract
Introduction
The Good
The Bad
The Ugly
Alterations of the Arterial Alveolus Gradient
Shunt
Ventilation / Perfusion Disturbance
Limitation of Diffusion
Dead Space
Alveolar Hypoventilation
Benefits of Non-Invasive Mechanical Ventilation in the Exchange of Gases
References
Chapter 3
Spontaneous Ventilation Determinants: Lung Compliance and Airway Resistance
Abstract
Lungs’ Elastic Recoil
Recoil of the Lung Forces
Action of Surfactant
Time Dependence of Pulmonary Elastic Behavior
Thoracic Cage Elastic Recoil
Lung Plus Thoracic Cage Pressure/Volume Relationships
Respiratory System Resistance
Gas Flow and Resistance Physical Principles
Laminar Flow
Turbulent Flow
Airway Resistance
Inertance and Respiratory System Resistance
References
Chapter 4
Pulmonary Function Monitoring. Implications for Respiratory Care in Non-Invasive Mechanical Ventilation
Abstract
Introduction
Physiological and Ventilatory Indicators During VMNI
Pulse Oximetry (SpO2)
Arterial Gasometry (ABG)
Transcutaneous CO2 Measurement (tcpCO2)
End-Tidal CO2 (ETCO2)
Respiratory Rate (RR)
Expiratory Tidal Volume (VTE)
I/E Ratio
Leaks
Positive Intrinsic Epiratory Pressure (PEEPi)
Waveforms
Patient-Ventilator Interaction
Alarms
Monitoring Categories / Monitoring Scales
Technological Advances in Monitoring Systems
Key Messages
References
Chapter 5
Waveform Analysis during Noninvasive Ventilation
Abstract
Abbreviations
Introduction
General Concepts
Scalar Graphics
Flow-Time (F-T)
Rise Time
Airway Obstruction
Air Trapping
Volume-Time (V-T)
Air Leak
Changes in Pulmonary Mechanics
Pressure-Time (P-T)
Patient-Initiated Breath
Loops
Pressure-Volume Loop (PVL)
Changes in Pulmonary Mechanics
Air Leak
Flow-Volume Loop (FVL)
/H3/Air Leak
/H1/Ventilator Mode Recognition
BIPAP
Conclusion
Key Messages
References
Chapter 6
Noninvasive Ventilatory Support. Technology, Devices, Classification and General Indications
Abstract
Introduction
Goals of Noninvasive Ventilation
Noninvasive Ventilation Technology
Driving Power/Energy
Control System and Sensors
Control and Phase Variables
Circuit
Patient Interface
Filters
Humidification
Display and Control Panel
Oxygen Inlet and Blender Systems
Electric Supply and Battery Backup
Devices and Classification of Noninvasive Ventilation
General Indications and Contraindications for Noninvasive Ventilation
Contraindications for Noninvasive Ventilation
Complications of Noninvasive Ventilation
Success of Noninvasive Ventilation
References
Chapter 7
Equıpment for Nonınvasıve Ventılatıon Physıcs and Prıncıples
Abstract
Abbrevıatıons
1. Introductıon
2. Methodology
2.1. Heating and Humidifying the Air Used During Noninvasive Mechanical Ventilation
2.2. Complications Related to Equipment
3. About Our Research
3.1. Learning Points
3.2. Critical Points
Conclusıon
References
Chapter 8
Nasal High Flow Oxygen. Technology and Devices
Abstract
Abbreviations
Nasal Interface
Flow Generator
Humidifying Devices
Inspiratory Limb
Conclusion
Key Messages
References
Chapter 9
Nasal High Flow Oxygen. Clinical Indications and Basic Respiratory Care
Abstract
Introduction
High Flow Nasal Cannula Mechanics Overview
Physiological Dead Space Washout and Increased Tidal Volume
Decreased Respiratory Rate
Positive End-Expiratory Pressure
Increased End-Expiratory Volume
Clinical Significance
Initial Settings and Adjustments
Where to Start
Flow Rate
FiO2
Humidification
Making Adjustments
Contraindications
Conclusion
References
Chapter 10
CPAP High Flow Oxygen Devices
Abstract
Introduction
Benefits
Constant Delivered FiO2
Positive End-Expiratory Pressure Generation
Fraction of Inspired Oxygen
Aerosol Therapy
Disadvantages of Using HFNC
References
Chapter 11
Mask Interface in Non Invasive Mechanical Ventilation(
Abstract
Introduction
Non-Invasive Interfaces
Oral Mask
Indications
Advantages
Disadvantages
Absolute Contraindications
Oral Mouthpiece
Indications
Advantages
Disadvantages
Absolute Contraindications
Nasal Mask
Indications
Advantages
Disadvantages
Absolute Contraindications
Nasal Pillows
Indications
Advantages
Disadvantages
Absolute Contraindications
Oronasal Mask (Full Face Mask)
Indications
Advantages
Disadvantages
Absolute Contraindications
Total Face Mask
Indications
Advantages
Disadvantages
Absolute Contraindications
Helmet
Indications
Advantages
Disadvantages
Absolute Contraindications
Troubleshooting
Air Leaks
Negative Effects
Solutions
Dead Space
Negative Effects
Solutions
Challenges with Pediatric Interfaces
Negative Effects
Solutions
Skin Breakdown
Negative Effects
Solutions
Conclusion
References
Chapter 12
Noninvasive Positive Pressure Ventilation Modes
Abstract
CPAP - Continuos Positive Airway Pressure
Bi-Level Modes Pressure
Pressure Support Ventilation (PSV)
Spontaneous Mode (S)
Spontaneous/Timed Mode (S/T)
Pressure Controlled Ventilation (PCV)
Timed Mode (T)
Proportional-Assist Ventilation (PAV)
Volume-Targeted Modes
Volume-Assured Pressure Support (VAPS)
Volume-Controlled Ventilation (VCV)
Conclusion
References
Chapter 13
Continuous Positive Airway Pressure (CPAP)
Abstract
Introduction
Concept and Physiopathology
Indications
CPAP Systems
Conclusion
References
Chapter 14
Bi-Level Positive Airway Pressure-BiPAP
Abstract
Introduction
Main Points
Conclusion
References
Chapter 15
Hybrid Ventilatory Modes AVAPS and NAVA
Abstract
Introduction
AVAPS
Setting of AVAPS
Indications of AVAPS
Advantages of AVAPS
NIV-NAVA
Setting of NAVA
Indications of NAVA
Advantages of NAVA
Key Messages
References
Chapter 16
Continuous Non-Invasive Ventilatory Support
Abstract
Introduction
Non-Invasive Ventilatory Support and Respiratory Mechanics
Chest Compliance
Resistances in Upper Airways
Use of Continuous Non-Invasive Ventilation and Choice of Mask Interface
Oronasal Masks
Nasal Masks
Mouthpiece
Factors that Assist in Adherence to Continuous Noninvasive Ventilatory Support in Neuromuscular Diseases - the Choice of Ventilators
Types of NIV Ventilators
Auxiliary Equipment - Mechanical Insufflation-Exsufflation Device
Pulmonary Insufflation Exercises
Impact of Noninvasive Ventilation on Oral Communication in Neuromuscular Diseases
Correlation between Lung Capacity and Speech Function
Noninvasive Ventilation and Swallowing in Neuromuscular Diseases
The Impact of Mask Interface on Speech and Swallowing Functions
Conclusion
Key Messages
References
Chapter 17
Methodology of Non Invasive Ventilation. Ventilator Settings and Withdrawal Protocols
Abstract
Introduction
High-Flow Nasal Cannula Oxygen Settings
Non-Invasive Mechanical Ventilation Settings
Prescription of Therapy
Weaning for Non-Invasive Mechanical Ventilation
Introduction
Weaning of Ventilation
Acknowledgments
References
Chapter 18
Asynchrony Non Invasive Ventilation. Implications for Respiratory Therapist
Abstract
Abbreviations
Introduction
Importance of Patient-Ventilator Interaction
NIV Asynchrony
NIV Failure
Leak Compensation
Improvement of NIV Synchronization
NIV Monitoring
Conclusion
References
Chapter 19
Non Invasive Mechanical Ventilation Complementary Technology for Non Invasive Ventilation Therapy. Humidification Devices
Abstract
Abbreviations
Introduction
Discussion and Analysis Main Topic
Normal Humidification
Humidification in NIV
Indications of Use
Contraindications of and Adverse Effects
Types of Humidifiers
Conclusion
Key Messages
References
Chapter 20
Management of Airway Secretions – Airway Clearance Therapy
Abstract
Introduction
Airway Clearance Therapy (ACT)
Postural Drainage and Breathing Exercises
Conclusion
References
Chapter 21
Respiratory Care and Non Invasive Ventilation. Aırway Secretıons Devıces
Abstract
Introduction
High Frequency Chest Wall Oscillation
Contraindications
Relative Contraindications
Intrapulmonary Percussive Ventilation
References
Chapter 22
Airway Secretions Devices: Mechanical Insufflator-Exsufflator- Cough Assisted
Abstract
Cough
Peak Cough Flow
Lung Volume Recruitment Techniques - Assisted Cough
Mechanical Insufflation-Exsufflation
Mechanical Insufflation-Exsufflation in Neuromuscular Diseases
Therapy Modes and Standard Treatment Procedures - Coughtassist( T70/E70 (Philips Respironics)
General Therapy Description [9-14]
Manual
Automatic
Cough-Trak
Oscillation
Adapting to the Patient – How to Start? [9-14]
References
Chapter 23
Aerosol Therapy Evidence in NIV-Nasal High Flow Aerosols- and Pharmacology
Abstract
1. Introduction
2. Physiological Rationale and Mechanism of Actions
2.1. Technical Features and Oxygenation Effect
2.2. Airways Ventilation Support
2.3. Humidification and Comfort
2.4. Mucociliary Clearance
3. Factors Affecting Aerosol Delivery During Non-Invasive Ventilation and High Flow Therapy
3.1. Airway Anatomy and Lung Disease Injury
3.2. Aerosol Generator Type in the Circuit
3.2.1. Nebulizers
3.2.2. pMDIs
3.3. Mode of Nebulizers
3.4. Aerosol Generator Type and Its Location within the Circuit
3.5. Nebulizer Dead Volume
3.6. Humidification and Heat of the Circuit
3.7. Gas Flow Rate
3.8. Gas Density
3.9. Interfaces
3.10. Aerosol Aerodynamic Effect
3.11. Patient Position
3.12. Ventilator-Associated Factors Affecting Aerosol Delivery
4. Current Clinical and Pharmacological Aerosol Therapy Applications During Ventilation Using NIV and HFT
4.1. Acute Hypoxemic Respiratory Distress
4.2. Acute COPD Exacerbations
4.3. Immunocompromised Patients with ARF
4.4. Cardiogenic Pulmonary Edema
4.5. Post-Extubation
4.6. Palliative Care
5. Patient Selection
6. Complications
7. Discontinuation
8. Prediction of NIV and HFT Failure
References
Chapter 24
Complications Noninvasive Ventilation. How Respiratory Therapists Act
Abstract
Introduction
Complications of Noninvasive Ventilation
Minor Complications [7, 8, 9, 10]
Subjective Mask Discomfort
Claustrophobia
Intolerance of the Technique
Skin Lesions
Acneiform Skin Rash
Necrosis of the Skin
Oral and Nasal Dryness
Nasal Congestion and Obstruction
Conjunctival Irritation
Major Complications [7, 8, 9, 10]
Air Leaks
Patient-Ventilator Dyssynchrony (PVD)
Hypercapnia
Gastric Insufflation
Barotrauma
Hemodynamic Alterations
Aspiration
Key Messages
References
Chapter 25
Aerosol Therapy during Non-Invasive Ventilation
Abstract
Introduction
Factors Affecting Aerosol Delivery druring NIV
Types of Aerosol Devices and Delivery Technique
Position of Aerosol Devices
Ventilator Modes and Parameters
Position of the Leak Port
Type of Exhalation Valve
Humidification
Type of Interface
Enhanced Condensational Growth
Conclusion
Key Messages
References
Chapter 26
Respiratory Care. Non Invasive Mechanical Ventilation and Use of Thoracic Ultrasound
Abstract
Introduction
Ultrasound Technique and Examination
Clinical Use of Ultrasound
Conclusion
References
Chapter 27
Non Invasive Mechanical Ventilation in Acute Cardiac Pulmonary Edema
Abstract
1. Introduction
2. Pathophysiology of Acute Heart Failure and Acute Cardiogenic Pulmonary Edema [6]
3. Benefit of Positive Airway Pressure in CPE: Pathophysiology
4. NPPV in ACPE: Current Evidence
4.1. NPPV in ACPE and Risk of Acute Myocardial Infarction (AMI)
5. Current Recommendations on NPPV for ACPE from International Societies
6. Risk Factors of Non-Invasive Ventilation Failure in Patients with ACPE
6.1. Consider ETI in ACPE, in Case of [5]
7. How to Program NPPV in ACPE [6]
7.1. Device Settings
7.2. Monitoring
Key Messages
References
Chapter 28
Non Invasive Ventilation in the Treatment of Pneumonia and Adult Respiratory Distress Syndrome
Abstract
Introduction
Patient Selection
Initiating NIV
Predictive Factors for NIV Failure
Discussion
References
Chapter 29
Non Invasive Mechanical Ventilation in Multiple Trauma - Blunt Chest Injury
Abstract
1. Introduction
2. Pathophysiology and Clinical Features
2.1. Rib Fractures and Flail Chest
2.1.1. Flail Chest
2.2. Lung Contusion
2.3. Pneumothorax
2.4. NIV and Blunt Thoracic Trauma (BTT)
2.4.1. Benefits of NIV in BTT Patients
2.4.2. Contraindications to NIV in BTT Patients
2.4.3. Indication for NIV in BTT Patients
2.4.4. Failure of NIV in BTT Patients
2.4.5. Comparison of Deferent Modes of NIV in BTT Patients
2.4.6. Side Effects of NIV in BTT Patients
Conclusion
Key Messages
References
Chapter 30
Non-Invasive Mechanical Ventilation in Immunocompromised Patients. Key Respiratory Care Issues
Abstract
Introduction
Current Evidence
Non-Invasive Ventilation
High Flow Nasal Therapy
Non-Invasive Ventilation versus Invase Ventilation
Conclusion
References
Chapter 31
Non Invasive Mechanical Ventilation in High-Risk Infections – Respiratory Care- SARS, MERS, pH1N1, Coronavirus
Abstract
Introduction
Management of Adults Hypoxemic Respiratory Failure Conditions in High Risk Infection– Options Available
NIPPV vs HFNO – A Balance between Advantages and Disadvantages
Some Particularities in Management of High-Risk Infections
Key Messages
References
Chapter 32
Respiratory Care in Non Invasive Ventilation Approach in Obstetrics
Abstract
Introduction
Respiratory Physiological Changes to Consider in Pregnancy
Upper Airway
Chest Wall
Respiratory Muscle
Static Lung Function
Spirometry
Airway Resistance and Conductance
Closing Volume
Diffusing Capacity
Minute Ventilation
Dead Space
Hyperventilation and Dyspnea
Oxygen Consumption and Production
Oxygen Tension
Arterial Blood Values
Principal Changes in Labor, Delivery and Postpartum
Causes of Respiratory Failure in Pregnancy
Non Invasive Ventilatory Management in the Pregnant Patient
Other Reasons to Take Into Account at the Moment to Use NIV in Pregnancy
Contraindications of NIV and Predictor of NIV Failure in Pregnancy
References
Chapter 33
Cardiothoracic and Neurologic Surgery
Abstract
1. Introduction
2. Physiologic Effects of NIV on Cardiopulmonary and Neurologic System
2.1. Heart and Circulation Effects
2.2. Central Nervous System (CNS)
3. Specific Sights of Surgery Impact on Patient
3.1. Cardiothoracic
3.2. CNS
3.3. Risk Factors for Postoperative Pulmonary Complications - ARF
4. Types of NIV
5. Benefits of NIV
6. Indications of NIV in Perioperative Period
7. Contraindications to NIV
8. NIV Failure
9. Complications of NIV
10. Patient Care
11. Perioperative NIV
11.1. Pre-Operative NIV
11.2. Intraoperative NIV
11.2.1. Cardiac Surgery
11.2.2. Thoracic Surgery
11.2.3. Neurosurgery
11.3. Postoperative NIV
11.3.1. Thoracic Surgery
11.3.2. Cardiac Surgery
11.3.3. Cranial Surgery
Conclusion
Key Messages
References
Chapter 34
Weaning/Extubation Respiratory Failure
Abstract
Introduction
Techniques of Respiratory Support after Extubation
Oxygen
Non-Invasive Ventilation
High-Flow nasal Therapy
Postextubation Ventilatory Support in Critically Ill Medical Patients
Preventive Strategy
Non-Invasive Ventilation vs Conventional Oxygen Therapy
High-Flow Nasal Therapy vs Conventional Oxygen Therapy
Non-Invasive Ventilation vs High-Flow Nasal Therapy
Facilitative Strategy
Therapeutic Strategy
Conclusion
References
Chapter 35
Tracheostomy Decannulation and Non Invasive Ventilation: Role of Respiratory Therapist
Abstract
Introduction
Clinical Stability
Airway Patency
Swallowing Assessment
Conscience Level
Coughing Effort
Management of Secretions
References
Chapter 36
Non Invasive Ventilation in Chronic Obstructive Pulmonary Disease
Abstract
Abbreviations
1. Introduction
2. Physiological Alterations in COPD Relevant to Ventilator Support
3. Indications of NIV in COPD
3.1. NIV in Acute Exacerbation
3.2. Long Term NIV in COPD
3.3. Home NIV for COPD
3.4. NIV to Facilitate Weaning in COPD
3.5. Non-Invasive Ventilation as an Addition to Pulmonary Rehabilitation in Severe Stable COPD
4. When to Stop NIV in COPD Patients
Conclusion
References
Chapter 37
Respıratory Care in Non Invasıve Mechanıcal Ventılatory Support: Cystıc Fıbrosıs (CF) Populatıon
Abstract
Introduction
Acute Exacerbation
Airway Clearance and Improvement in Quality of Life
Chronic Maintenance Therapy/Bridge to Transplantation
Conclusion
References
Chapter 38
Non Invasive Mechanical Ventilation in Asthma Exacerbation
Abstract
Introduction
Risk Factors Associated to Asthma Exacerbation
Pathophisiology of Asthma Exacerbations
Benefits of NIV
Selecting the Patient
Programming NIV
Discontinuation
Conclusion
References
Chapter 39
Neuromuscular Disorders
Abstract
Definition and Classification of Neuromuscular Disorders
Pathophysiology of NMD
Epidemiology of NMD
Impact of Neuromuscular Diseases on the Respiratory System
Respiratory Muscle Strength
Cough Function Abnormalities
Sleep Abnormalities
Reduction in Respiratory System Compliance
Methods of Assessment
Spirometry
Mouth Pressures and Sniff-Nasal Inspiratory Pressure
Peak Cough Flow
Sleep Studies
Blood Gases
Imaging
Monitoring
Treatment Options
Non-Invasive Ventilation
Assisted Coughing
Long Term Oxygen Therapy e Bronchodilators
Sialorrhea Management
Neurogenic Dysphagia Management
References
Chapter 40
Noninvasive Mechanical Ventilation in Chest Wall Respiratory Disorders. Respiratory Care
Abstract
Introduction
Pathophysiology of Chest Wall Abnormalities and Respiratory Failure
Mechanism and Benefits of NIV in Chest Wall Disorders
Patient Selection
High Risk Patients for Respiratory Failure
Therapy in Patients with Installed Respiratory Failure
Contraindications
Initiation and Monitoring of NIV
Key Messages
References
Chapter 41
Non Invasive Ventilation for Patients with Obesity Hypoventilation and Acute Hypercapnic Respiratory Failure
Abstract
Introduction
Review Method
Management of Acute-on-Chronic Exacerbation in Patients with OHS
Oxygen Therapy
Positive Airway Pressure Therapy
Noninvasive Ventilation in Acute-On-Chronic Exacerbation of OHS
Other Ventilatory Modes
Dedicated NIV versus ICU Ventilators
Predictors of Failure of NIV
Conclusion
Acknowledgments
References
Chapter 42
Non Invasive Mechanical Ventilation in Sleep Breath-ing Disorders
Abstract
Introduction
Choosing, Initiation and Titration of Non Invasive Ventilation (NIV) in Sleep Disorders
Sleep Apnoea (Obstructive or Central)
Obstructive Sleep Apnoea (OSA)
Central Sleep Apnoea (CSAS)
Sleep-Related Hypoventilation (Obesity or Neuromuscular Disorders)
Obesity-Hypoventilation Syndrome
Neuromuscular Diseases
Sleep-Breathing Disorders Associated with Chronic Respiratory Disorders
Conclusion
Key Messages
References
Chapter 43
Non Invasive Mechanical Ventilation: Neuropsychiatric Disorders and Respiratory Care in Elderly People
Abstract
Introduction
Delirium
Dementia
The Management of Behavioral Disorders
Drug Therapy
Delirium Treatment
Drug Therapy of Behavioral Disorders in the Person with Dementia (BPSD)
Treatment of Affective Symptoms
Treatment of Neuro-Vegetative Symptoms
Disorders of Sexual Behavior
Eating Disorders
Treatment of Specific Behaviors
Recommendations of the Italian Medicines Agency (AIFA) on the Pharmacological Management of BPSD
Physical Restraint
References
Chapter 44
Non Invasive Mechanical Ventilation and Respiratory Physiotherapy and Pulmonary Rehabilitation
Abstract
Respiratory Physiotherapy
Manual Techniques and Exercises
Mechanical Techniques and Devices
Mobilization
Weaning and Decannullation
Pulmonary Rehabilitation
References
Chapter 45
Non Invasive Ventilation in Bronchoscopy and Sedation. Implications for Respiratory Therapist
Abstract
History of Bronchoscopy
Sedation for the Bronchoscopy Patient
Moderate Sedation
Deep Sedation
Indications for Bronchoscopy
Contraindications for Bronchoscopy
Bronchoscopes
Standard Practice for Bronchoscopy Procedures
Complications of Bronchoscopy
Workflow Chart
References
Chapter 46
Non Invasive Ventilation in Non-Bronchoscopy Sedation (Cardiology - Gastroenterology, Catheter Insertion). Implications for Respiratory Therapist
Abstract
1. Introduction
2. Types of NIV
3. NIV Mask Selection
4. Benefits of NIV
5. Indications for NIV in Sedation Procedures
6. Contraindications to NIV in Sedation Procedures
7. Side Effects of NIV
8. Failure Criteria for NIV
9. Patient Care
10. Recent Findings
10.1. NIV in Gastroenterology
10.2. NIV in Cardiology
Conclusion
Key Messages
References
Chapter 47
Nasal High Flow Use in COPD
Abstract
Introduction
Indications
References
Chapter 48
Hospital Discharge Program to Home Care Non-Invasive Ventilation
Abstract
1. Introduction
2. Objectives
3. Methodology
3.1. Clinical Situations
3.2. Criteria
3.3. Voluntary Participation
4. Process
4.1. Process of Equipping the Patient’s Home
4.2. NIV Process of Installation at Home
4.3. Monitoring Process
4.4. Personnel Evaluation Process
5. Adverse Effects
6. Contraindications to Home Mechanical Non-Invasive Ventilation (Hnmv)
7. Benefits of Home Mechanical Home Ventilation
Conclusion
Key Messages
References
Chapter 49
Home Non Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disorders. Role of Respiratory Therapist
Abstract
Introduction
Physiopathological Basis
Indications of Non-Invasive Home Mechanical Ventilation in Stable EPOC
Other Factors Related to the Effectiveness of Home Noninvasive Mechanical Ventilation
Key Messages
References
Chapter 50
Home Non Invasive Mechanical Ventilation in Neuromuscular Disorders: Implications for Respiratory Therapist
Abstract
1. Introduction
2. Pathophysiology of NIV in Patients with Neuromuscular Diseases
3. Indications and Contraindications
4. Equipment and Modalities of Home Noninvasive Ventilation
4.1. CPAP (Continuous Positive Airway Pressure)
4.2. BiPAP (Bilevel Positive Airway Pressure)
5. Home NIV and the Pediatric Patient
6. Home NIV in Adult Patients
7. When to Institute Home NIV
8. Care in Home Care
Conclusion
References
Chapter 51
The Use of Non-Invasive Ventilation in Prolonged Mechanical Ventilation and Respiratory Care
Abstract
Introduction to Prolonged Mechanical Ventilation
Using NIV on Specialty Weaning Units
Conclusion
References
Chapter 52
Respiratory Care and Non Invasive Ventilation in Neonatology
Abstract
Abbreviations
Introduction
Nasal Continuous Positive Airway Pressure (NCPAP)
Physiological Effects
Indications
Application Methods and Systems
Methods for Providing NCPAP
Failure of CPAP
Nasal Intermittent Positive Pressure Ventilation (NIPPV)
Physiological Effects
Devices
Optimal Parameters
NCPAP/NIPPV Removal
Non-Invasive High-Frequency Oscillatory Ventilation (NHFOV)
Complications of NIV
Nasal Injury: Nasal Mucosa/Nasal Septum
References
Chapter 53
Assessment of Pain/Distress During Non Invasive Ventilation in Pediatric and Respiratory Care
Abstract
MeSH Terms
Nasal Injuries: Effect of NIV Interface
Causes of Pain in ICU
Barriers to Effective Pain Management in the ICU
Phase of Life with Psychological Responses to Pain and Distress
How to Assess Pain in Conscious Children Receiving NIV?
How to Assess Pain in Sedated Children Receiving NIV?
Long Term Negative Effects of Acute Postoperative Pain
Pain in ICU Should Be Treated Properly
References
Chapter 54
Aspects of Psychological Support for Children During Respiratory Care (Non-Invasive Ventilation)
Abstract
Introduction
Claustrophobia
Agitation and Delirium
Anxiety
Dyspnea During NIMV
Dependence and Autonomy
Post-Traumatic Stress Syndromes
Management
References
Chapter 55
Counseling of Parents, Ethical Aspects, Consent, or Ascent for Children for Preparing the Family Members for Shifting Care from Ward to Home: Educational and Training Aspects for Respiratory Therapist
Abstract
Introduction
Respiratory Care: From Hospital to Home
Home NIV: Obstacles and Ways to Overcome Them
Training of the Affected Child
Importance of Understanding the Psychology of the Child
Training of the Caregiver
Ethical Aspect: ‘Consent’ or ‘Assent’ and Implication of Age
Counselling of Parents
End-of-Life Care, Palliative Care, and ‘Comfort Measures Only’
References
Chapter 56
Respiratory Care in Intrahospital and Prehospital Patients with Non Invasive Ventilator Support
Abstract
Abbreviations
Introduction
Intra-Hospital Transport and NIV
Selection of Candidates for Intra-Hospital NIV Transport
Provision Resources
Equipment Required during NIV Transport
Control and Monitoring
Pre-Hospital Transport and NIV
NIV Indications and Selection of Patients to Be Transported on NIV
Provision Resources
Control and Monitoring
Conclusion
Key Messages
References
Chapter 57
Non Invasive Ventilation in Critical Care. General Aspects for Respiratory Therapists
Abstract
Introduction
Before Starting NIV
Patient Selection
COPD Exacerbations
Acute Cardiogenic Pulmonary Edema (ACPE)
Asthma
Postextubation
Other Diseases
Interface Selection
Humidification
Practical Guidelines
COPD Exacerbation
Acute Cardiogenic Pulmonary Edema
Asthma
Conclusion
References
Chapter 58
Non-Invasive Ventilation-Respiratory Care. Organization in Critical Care Unit
Abstract
Introduction
Equipment
Caregiver’s Training
Organization
Advantages And Disadvantages
Management of NIMV in ICU
References
Chapter 59
Respiratory Care in Anesthesiology Pre-Intubation and Upper Airways Procedure
Abstract
Introduction
Physiologic Basis of Preoxygenation and Apneic Oxygenation
High-Risk Patients of Hypoxemia
Elderly Patients
Morbid Obesity
Pulmonary Disease
Critically Ill Patients
Modalities of Preoxygenation and Apneic Oxygenation in Patient at High Risk of Hypoxemia
High-Flow Nasal Oxygen (HFNO)
Noninvasive Ventilation (NIV)
Preoxygenation in the Patient at High Risk of Hypoxemia. Recommendations
Noninvasive Ventilation in Procedures Involving the Airway
References
Chapter 60
Respiratory Care and Non Invasive Ventilation. Anesthesiology and Postoperative Medicine
Abstract
Introduction
Who Will Need NIMV? [5]
Contraindications for NIMV in the Postoperative Period [5]
What Goals of Therapy Can Be Achieved with NIMV in the Postoperative Patient with ARF? [6]
Patients Who May Benefit from Postoperative Use of NIMV [7]
NIMV in the Postoperative Period of Abdominal Surgery
NIMV in the Postoperative Period of Bariatric Surgery
NIMV in the Postoperative Period of Thoracic Surgery
NIMV in the Postoperative Period of Lung Transplant
NIMV in the Postoperative Period of Liver Trasplant
Evidence on Postoperative Use of NIMV [11]
Key Messages
References
Chapter 61
Respiratory Care in Non Invasive Ventilation in Ward
Abstract
Introduction
Conclusion
References
Chapter 62
Respiratory Care in Noninvasive Ventilation-Post-Intensive Care Step Down Unit
Abstract
Introduction
History of Noninvasive Ventilation and Step Down Units
Step Down Unit Clinical Outcomes
Step Down Units and Clinical Deterioration
References
Chapter 63
Respiratory Therapist Education, Policies, and Protocols. Key Recommendations
Abstract
Introduction
ADDIE
Policies and Procedures
References
About the Editors
Index
Blank Page