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Noninvasive Ventilation in the Perioperative Period

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Abstract

High-flow nasal therapy (HFNT), as well as noninvasive ventilation (NIV), represents both noninvasive supports. HFNT is a ventilator support where humidified and heated gases are administered to the patient’s airways by a small nasal cannula at flow that reach up to 60 L/min. The delivered flow can be combined with oxygen providing different inspiratory oxygen fractions (FiO2). HFNT is increasingly used for critically ill adult patients in different clinical settings. Differently from noninvasive ventilation (NIV) which is intended to deliver intermittent positive pressure ventilation (NIPPV) or continuous positive airway pressure (CPAP) to the patient’s airway via different external interfaces, HFNT acts through different physiological mechanisms only partially associated to the production of an end-expiratory airway pressure. HFNT may have some advantages compared to NIV including possible better comfort, less need of workloads, and less equipment. However it deserves strict monitoring to avoid, in specific settings (e.g., hypoxemic patients), delay in escalating support and endotracheal intubation.

The aim of this review is to provide an overview, practical advices, and current evidence about the application of NIV and HFNT in perioperative medicine.

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Tramarin, J., Cortegiani, A., Gregoretti, C. (2019). Noninvasive Ventilation in the Perioperative Period. In: Chiumello, D. (eds) Practical Trends in Anesthesia and Intensive Care 2018. Springer, Cham. https://doi.org/10.1007/978-3-319-94189-9_8

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