Explain Ventilation (NIV)?
This refers to the use of mechanical ventilatory support without the use of an endotracheal tube. NIV may be by the application of a continuous positive pressure at expiration, called Continuous Positive Airway Pressure (CPAP). This would help to open up or "recruit" collapsed alveoli and thus improve oxygenation. In addition, the inspiratory phase can also be supported with a set level of pressure, thus providing ventilatory support as well and thus reduce the work of breathing. This is called Non Invasive Positive Pressure Ventilation (NIPPV). For NIV to be safe and effective, the patient should be awake, able to breathe spontaneously and maintain and protect the airway. The obvious advantages over intubation and ventilation are avoidance of airway trauma, reduced incidence of nosocomial pneumonias, possible reduction of ICU and hospital stay and mortality in select groups of patients. NIV may be particularly useful in acute exacerbations of COPD, cardiogenic pulmonary edema and in immunocompromised patients.