Non-Invasive Ventilation: Gentle And Cost-Effective Therapy - Non invasive ventilation: Caregiver adjusts Drägers NIV full face-mask for niv ventilation therapy

Non-Invasive Ventilation: Gentle And Cost-Effective Therapy

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Non-Invasive Ventilation and Non-Invasive Ventilation Types

Non-invasive ventilation (NIV) is ventilator support given to patients without the use of an endotracheal tube. It assists in avoiding the potential complications of invasive mechanical ventilation. It also helps to deliver cost-effective therapy with decreased length of stay in the ICU and an improved chance of survival.2,5 NIV is used for patients with acute and chronic respiratory failure and also to support weaning therapy. As Your Specialist in Acute Care, we are able offer multiple options for the delivery of non-invasive ventilation or non-invasive ventilation types. 

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NIV brings patients many benefits

  • Fewer complications: NIV reduces the number of possible complications by 62% and treatment errors by 50%.1
  • Shorter stay in ICU: NIV shortens ICU stay and reduces the length of hospital stay by an average of 3 days.2
  • Increased quality of life: NIV increases the quality of life for patients.1,3,4
  • Better chance of survival: A meta-analysis suggested that NIV improved survival in acute care settings – and that it is more beneficial when applied earlier rather than as a rescue therapy.5
  • Reduced risk of infection: The use of NIV instead of mechanical ventilation is associated with a lower risk of nosocomial infections. A study has shown significantly more infectious complications related to the presence of the endotracheal tube.6, 7
Non-Invasive Ventilation: Gentle And Cost-Effective Therapy - Improve outcome with non-invasive ventilation and the right choice of interface

Improving outcomes with NIV and the right choice of interface

The advantages are clear, and the development continues. Learn more about how non-invasive ventilation improves patient outcome and comfort.

Rotation strategies can improve NIV tolerance

Non-invasive respiratory support encompasses CPAP (continuous positive airway pressure). This is delivered via an external interface such as a nasal mask, oronasal mask, or total-face mask. Two key factors involved in successful NIV treatment are the rotation of mask type and choice of interface. Studies have proven that alternating different mask types improves the effectiveness of treatment when treating acute respiratory failure. Furthermore, selecting the correct type of interface greatly reduces painful skin breakdown and ulcerations. Thus, an alternating interface strategy not only reduces the points of highest pressure, but also improves NIV tolerance and efficacy.7, 8

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The benefit of NIV in the treatment of ARDS

Acute respiratory distress syndrome (ARDS) is characterized by acute onset respiratory failure, diffuse pulmonary opacities and severe hypoxemia. Invasive mechanical ventilation is often the standard of care for the management of ARDS. However, invasive ventilation is associated with several complications, including a higher incidence of ventilator-associated pneumonia and barotrauma. The use of NIV can help to avoid such complications.

Dräger Carina ventilator case study

Case study

A hospital in Kiel, Germany, presents the following case study to report on their experience with the Dräger Carina ventilator when used to prevent intubation on seriously ill patients with ARDS. Of particular note from Dr. Anke Jansen, Head of ICU, was the high degree of patient comfort thanks to the excellent trigger sensitivity of the Carina ventilator.

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Additional insight

Acute Non-Invasive Ventilation: Initiation & Weaning, COPD and Beyond... by Dr Nicholas Hart

Clinical evidence for NIV

Dr Nicholas Hart, the Clinical and Academic Director at the Lane Fox Respiratory Unit, St Thomas' Hospital, London, explains the clinical use of NIV. The symposium focuses on various topics that are particularly interesting in the context of NIV, such as COPD.

A look at NIV in the paediatric intensive care unit (PICU)

In the UK and Ireland, NIV is being used more and more often in PICUs over the past 10 years, as shown by the national audit data, per NCBI. This data reflects an international trend of greater adoption of NIV. Take a look at some of the reports and studies relating to NIV in the PICU.

Non-invasive ventilation fact sheet

Fact sheet: non-invasive ventilation

NIV has helped lead to a reduction of infectious complications, reduced length of stay in the ICU, reduced intubation rates and therefore better outcomes. Together, this has helped reduce overall costs. Take a look at this overview of the benefits of NIV based on scientific literature.

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More suggested downloads

Non-invasive ventilation, a century of experience booklet
Non-invasive ventilation – A century of experience

Get some insight into how the understanding and clinical use of NIV has evolved over time.

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British Thoracic Society NIV quality standards guide
British Thoracic Society: NIV quality standards

Take a look at this guide to learn more about the standards of care for acute non-invasive ventilation in adults.

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References/ Sources

1 Ferrer M, et al. Non-invasive Ventilation during Persistent Weaning Failure. Am. J. Respir. Crit. Care Med. 2003; Vol. 168, No. 1:70–76. (PubMed)

2 Warren DK, et al. Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med. 2003; 31(5):1312-7. (PubMed)

3 Nava S, et al. Time of non-invasive ventilation. Intensive Care Med. 2006 Mar; 32(3):361-70. (PubMed)

4 Bülow HH, et al. Experiences from introducing non-invasive ventilation in the intensive care unit: a 2-year prospective consecutive cohort study. Acta Anaesthesiol Scand 2007; 51:165-170. (PubMed)

5 Cabrini L, et al. Non-invasive ventilation and survival in acute care settings: a comprehensive systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2015; 43(4):880-8.

6 _ Antonelli M, et al. * A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure.  _N Engl J Med 1998, 339: * 429-435.

7 Hilbert G, Gruson D, Gbikpi-Benissan G, Cardinaud JP. Sequential use of noninvasive pressure support ventilation for acute exacerbations of COPD. Intensive Care Med. 1997;23:955–961. 

8 Ozyilmaz E et al*.* Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies. BMC Pulm. Med. 2014; 14:19