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Respiratory Care
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Enhancing noninvasive ventilation (NIV) can help improve patient care

 

Rethink respiratory care

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Learn more about hospital respiratory care solutions including high-flow oxygen therapy (HFT), noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV).
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It’s a challenge to keep up with the latest innovations in hospital respiratory care: high-flow oxygen therapy (HFT), noninvasive ventilation (NIV), invasive mechanical ventilation (IMV). While often complementary, these techniques aren’t always interchangeable. Understanding which technique is appropriate and when, can help improve patient care and assist clinical teams for success.

High flow therapy

High flow therapy (HFT) delivers:

  • Appropriate flow demand
  • Wide range of FiO2
  • Small PEEP effect
  • CO2 washout
  • Heated humidification

Noninvasive ventilation support

Noninvasive ventilation (NIV) support delivers:

  • Appropriate noninvasive ventilatory support
  • Adjustable IPAP (Pressure Support) levels
  • Adjustable EPAP (PEEP) levels
  • Back-up rate
  • Wide range of FiO2
  • Patient monitored parameters and alarms
  • The same physiological effect as invasive mechanical ventilation

Determine the optimal respiratory technique for optimal care

Click the respiratory technique below to align with patient severity.

Low flow oxygen therapy

Nasal cannula or non-rebreathing mask, 21-100% O2, FiO2 a function of inspiratory flow rate1

Acute respiratory slide 1
High flow oxygen therapy

Nasal cannula, 21-100% O2 with high flow rates of 40 to 100 L/min, highly humidified, clears dead space, limited and variable PEEP1

acute respiratory slide 2
Noninvasive ventilation

Face mask, 21 to 100% O2, PEEP and PS controllable, various modes, monitoring and alarms1

acute respiratory slide 3
Invasive mechanical ventilation

ET tube/trach, 21-100% O2, PEEP and higher levels of PS available, various modes, monitoring and alarms2

acute respiratory slide 4
Invasive mechanical ventilation and ECMO

ET tube/trach, 21-100% O2, higher levels of PEEP and lower levels of tidal volume, monitoring and alarms2

acute respiratory slide 5

Timely transition of therapies is important - whether escalation or de-escalation of therapy - or providing HFT between NIV sessions. Although the ability to escalate therapy is important, preventing the delay of intubation in patients who need invasive mechanical ventilation requires understanding and recognition of predictors of failure.

Non-inferiority study icon

                In a recent non-inferiority study,

87%

                of patients who were placed on
                NIV after failing on HFT avoided
                intubation.3

In a recent non-inferiority study,

87%

of patients who were placed on NIV after failing on HFT avoided intubation.3

Clinical insights

Are HFOT and NIV complementary for acute respiratory failure?

FJ Belda, MD, PhD

Providing evidence- based care to patients in need of respiratory support

T Piraino, RRT, FCSRT

Evidence-based practice for noninvasive ventilation and high flow nasal cannula

T Piraino, RRT, FCSRT

High Flow Nasal Cannula and Non-Invasive Ventilation

Webinar: High flow nasal cannula and non-invasive ventilation

 

T Piraino, RRT, FCSRT

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Related content

Succeed in Respiratory Care

Succeed in Respiratory Care: NIV and High-Flow Oxygen Therapy

Hospital Respiratory Ventilation Solutions

Hospital Respiratory Ventilation Solutions

References:

1. Drake. High-Flow Nasal Cannula Oxygen in Adult: An Evidence-based Assessment. Ann Am Thoracic Society. 2018;15(2): 145-155.

2. Schmidt, Pellegrino, Combes, Scheinkestel, Cooper, Hodgson. Mechanical ventilation during extracorporeal membrane oxygenation. Critical Care. 2014;18:203.

3. Piraino. Noninvasive Respiratory Support in Acute Hypoxemic Respiratory Failure. Respir Care 2019;64(6):638 –646.

4. Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ 2003; 326 doi

5. Experiences of noninvasive ventilation in adults with hypercapnic respiratory failure: a review of evidence. Hamadziripi Ngandu, Nichola Gale, Jane B. Hopkinson; European Respiratory Review Dec 2016, 25 (142) 451-471; DOI: 10.1183/16000617.0002-2016

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