Abstract
There are certain indications for which noninvasive ventilation (NIV) can be initiated outside the intensive care unit (ICU). However, there should be a clear policy for such admissions based on the clinical condition which includes hemodynamic stability, consciousness, pH from a blood gas, and the indication for NIV. The location where NIV is started should have continuous monitoring of hemodynamics, consciousness, oxygenation, respiratory rate, and acid-base status. The nursing staff involved should be trained in managing patients with NIV and also proficient in basic troubleshooting of the ventilators. The nursing staff needs to be instructed regarding when to raise an alarm or inform the ICU outreach team in case they anticipate a failure of NIV requiring ICU admission of these patients for further management and if necessary, invasive ventilation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tomii K, Seo R, Tachikawa R, Harada Y, Murase K, Kaji R, Takeshima Y, Hayashi M, Nishimura T, Ishihara K. Impact of noninvasive ventilation (NIV) trial for various types of acute respiratory failure in the emergency department; decreased mortality and use of the ICU. Respir Med. 2009;103:67–73.
De Robertis E, Iannuzzi M, Tufano R, Piazza O. Pre- and in-hospital non-invasive ventilation. Transl Med UniSa. 2011;1:229–36.
Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000;355(9219):1931–5.
Faqihi BM, Parekh D, Trethewey SP, Morlet J, Mukherjee R, Turner AM. Ward-based noninvasive ventilation for acute hypercapnic respiratory failure unrelated to chronic obstructive pulmonary disease. Can Respir J. 2021;2021:4835536.
Cabrini L, Esquinas A, Pasin L, Nardelli P, Frati E, Pintaudi M, Matos P, Landoni G, Zangrillo A. An international survey on noninvasive ventilation use for acute respiratory failure in general non-monitored wards. Respir Care. 2015;60:586–92.
Cabrini L, Antonelli M, Savoia G, Landriscina M. Non-invasive ventilation outside of the intensive care unit: an Italian survey. Minerva Anestesiol. 2011;77:313–22.
Cabrini L, Idone C, Colombo S, Monti G, Bergonzi PC, Landoni G, Salaris D, Leggieri C, Torri G. Medical emergency team and non-invasive ventilation outside ICU for acute respiratory failure. Intensive Care Med. 2009;35:339–43.
Trethewey SP, Edgar RG, Turner AM, Mukherjee R. Ward-based non-invasive ventilation in acute exacerbations of COPD: a narrative review of current practice and outcomes in the UK. Healthcare (Basel). 2018;6:145.
Farha S, Ghamra ZW, Hoisington ER, Butler RS, Stoller JK. Use of noninvasive positive-pressure ventilation on the regular hospital ward: experience and correlates of success. Respir Care. 2006;51:1237–43.
Cabrini L, Monti G, Villa M, Pischedda A, Masini L, Dedola E, Whelan L, Marazzi M, Colombo S. Non-invasive ventilation outside the intensive care unit for acute respiratory failure: the perspective of the general ward nurses. Minerva Anestesiol. 2009;75(7–8):427–33.
Vatrella A, Fabozzi I. Non invasive ventilation away from ICU. Transl Med UniSa. 2012;2:64–5.
Ergan B, Nasiłowski J, Winck JC. How should we monitor patients with acute respiratory failure treated with noninvasive ventilation? Eur Respir Rev. 2018;27(148):170101.
Defilippis V, D'Antini D, Cinnella G, Dambrosio M, Schiraldi F, Procacci V. End-tidal arterial CO2 partial pressure gradient in patients with severe hypercapnia undergoing noninvasive ventilation. Open Access Emerg Med. 2013;5:1–7.
Cox M, Kemp R, Anwar S, Athey V, Aung T, Moloney ED. Non-invasive monitoring of CO2 levels in patients using NIV for AECOPD. Thorax. 2006;61:363–4.
Georges M, Rabec C, Monin E, Aho S, Beltramo G, Janssens JP, Bonniaud P. Monitoring of noninvasive ventilation: comparative analysis of different strategies. Respir Res. 2020;21:324.
Abramovitz A, Sung S. Pressure support ventilation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021; 2022.
Masip J. Noninvasive ventilation in acute heart failure. Curr Heart Fail Rep. 2019;16:89–97.
MacIntyre NR. Physiologic effects of noninvasive ventilation. Respir Care. 2019;64:617–28.
Corral J, Mogollon MV, Sánchez-Quiroga MÁ, Gómez de Terreros J, Romero A, Caballero C, Spanish Sleep Network, et al. Echocardiographic changes with non-invasive ventilation and CPAP in obesity hypoventilation syndrome. Thorax. 2018;73:361–8.
Duan J, Han X, Bai L, Zhou L, Huang S. Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients. Intensive Care Med. 2017;43:192–9.
Duan J, Wang S, Liu P, Han X, Tian Y, Gao F, et al. Early prediction of noninvasive ventilation failure in COPD patients: derivation, internal validation, and external validation of a simple risk score. Ann Intensive Care. 2019;9:108.
Guia MF, Boléo-Tomé JP, Imitazione P, Polistina GE, Alves C, Ishikawa O, et al. Usefulness of the HACOR score in predicting success of CPAP in COVID-19-related hypoxemia. Respir Med. 2021;187:106550.
Ding M, Han X, Bai L, Huang S, Duan J. Impact of HACOR score on noninvasive ventilation failure in non-COPD patients with acute-on-chronic respiratory failure. Can Respir J. 2021;2021:9960667.
Magdy DM, Metwally A. The utility of HACOR score in predicting failure of high-flow nasal oxygen in acute hypoxemic respiratory failure. Adv Respir Med. 2021;89:23–9.
Ferreira R. Interfaces, circuits and humidifiers. Front Pediatr. 2020;8:557301.
Nava S, Navalesi P, Gregoretti C. Interfaces and humidification for noninvasive mechanical ventilation. Respir Care. 2009;54:71–84.
Pavone M, Verrillo E, Onofri A, Caggiano S, Cutrera R. Ventilators and ventilatory modalities. Front Pediatr. 2020;8:500.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Nair, A.S., Manhas, Y. (2023). Safety Recommendations for Noninvasive Ventilation Outside Intensive Care Unit. In: Esquinas, A.M., Spicuzza, L., Scala, R. (eds) Noninvasive Ventilation Outside Intensive Care Unit. Noninvasive Ventilation. The Essentials. Springer, Cham. https://doi.org/10.1007/978-3-031-37796-9_9
Download citation
DOI: https://doi.org/10.1007/978-3-031-37796-9_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-37795-2
Online ISBN: 978-3-031-37796-9
eBook Packages: MedicineMedicine (R0)