Non-invasive Ventilation in Critical Care
Tracheal intubation and mechanical ventilation (MV) are supportive interventions that may be life saving in critically ill patients but also involve a significant risk of morbidity and mortality. Averting the need for MV, or reducing the time patients spend on MV, may decrease the risk of several serious problems such as ventilator-associated pneumonia, sedation-related problems, and sinusitis and may also improve patient mortality in several different clinical situations.
Non-invasive ventilation (NIV) is defined as 'delivery of ventilatory support via the patient's upper airway using a mask or similar device' and includes both continuous positive airway pressure (CPAP) and non-invasive positive pressure ventilation (NPPV). NIV was initially used to treat type II respiratory failure and prevent the need for MV and the attendant complications associated with invasive ventilation but is now emerging as a useful alternative treatment strategy to MV in a number of different clinical situations.
Worldwide, the use of NIV has more than doubled in the past 10 yr. In the UK where the previous decade has seen a disproportionate increase in level 2 critical care beds, NIV use has risen steadily. Yet, large international geographical variations remain and NIV use remains relatively low in areas such as North America.
Abstract and Introduction
Introduction
Tracheal intubation and mechanical ventilation (MV) are supportive interventions that may be life saving in critically ill patients but also involve a significant risk of morbidity and mortality. Averting the need for MV, or reducing the time patients spend on MV, may decrease the risk of several serious problems such as ventilator-associated pneumonia, sedation-related problems, and sinusitis and may also improve patient mortality in several different clinical situations.
Non-invasive ventilation (NIV) is defined as 'delivery of ventilatory support via the patient's upper airway using a mask or similar device' and includes both continuous positive airway pressure (CPAP) and non-invasive positive pressure ventilation (NPPV). NIV was initially used to treat type II respiratory failure and prevent the need for MV and the attendant complications associated with invasive ventilation but is now emerging as a useful alternative treatment strategy to MV in a number of different clinical situations.
Worldwide, the use of NIV has more than doubled in the past 10 yr. In the UK where the previous decade has seen a disproportionate increase in level 2 critical care beds, NIV use has risen steadily. Yet, large international geographical variations remain and NIV use remains relatively low in areas such as North America.
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