Use of NIV in Non-surgery Procedures in Elderly (Sedation, Bronchoscopy, Gastroscopy)

  • Raffaele Scala


Sedation during noninvasive ventilation (NIV) to avoid endotracheal intubation (ETI) in poorly compliant subjects and the employ of NIV to support high-risk patients undergoing bronchoscopic and gastroscopic procedures in elderly still represents an “unconventional evidence-based” field of application of this popular ventilator technique. However, due to the increasing proportion of fragile elder patients with underlying cardiopulmonary comorbidities and/or immunosuppression-associated conditions, in the “real life” NIV often remains the “ceiling supportive ventilation” for this do-not-intubated (DNI) population and is likely to be push-up forward the evidence-based indications (i.e., COPD exacerbations, cardiogenic pulmonary edema, weaning/postextubation in hypercapnic patients, respiratory distress in immunosuppressive status). Sedation-based strategy to rescue elder patients with poor NIV cooperation and/or adaptation and use of NIV to support elderly during interventional pulmonary and gastroenterologic procedures are the issues that are reported in this chapter.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Raffaele Scala
    • 1
  1. 1.Pulmonology and Respiratory Intensive Care UnitS. Donato HospitalArezzoItaly

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