Skip to main content

Safety Recommendations for Noninvasive Ventilation Outside Intensive Care Unit

  • Chapter
  • First Online:
Noninvasive Ventilation Outside Intensive Care Unit

Part of the book series: Noninvasive Ventilation. The Essentials ((NVE))

  • 171 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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.

    Article  PubMed  Google Scholar 

  2. De Robertis E, Iannuzzi M, Tufano R, Piazza O. Pre- and in-hospital non-invasive ventilation. Transl Med UniSa. 2011;1:229–36.

    PubMed  PubMed Central  Google Scholar 

  3. 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.

    Article  CAS  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. 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.

    CAS  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    PubMed  Google Scholar 

  10. 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.

    CAS  PubMed  Google Scholar 

  11. Vatrella A, Fabozzi I. Non invasive ventilation away from ICU. Transl Med UniSa. 2012;2:64–5.

    PubMed  PubMed Central  Google Scholar 

  12. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 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.

    PubMed  PubMed Central  Google Scholar 

  14. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Abramovitz A, Sung S. Pressure support ventilation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021; 2022.

    Google Scholar 

  17. Masip J. Noninvasive ventilation in acute heart failure. Curr Heart Fail Rep. 2019;16:89–97.

    Article  PubMed  Google Scholar 

  18. MacIntyre NR. Physiologic effects of noninvasive ventilation. Respir Care. 2019;64:617–28.

    Article  PubMed  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  CAS  PubMed  Google Scholar 

  21. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. Ferreira R. Interfaces, circuits and humidifiers. Front Pediatr. 2020;8:557301.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nava S, Navalesi P, Gregoretti C. Interfaces and humidification for noninvasive mechanical ventilation. Respir Care. 2009;54:71–84.

    PubMed  Google Scholar 

  27. Pavone M, Verrillo E, Onofri A, Caggiano S, Cutrera R. Ventilators and ventilatory modalities. Front Pediatr. 2020;8:500.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abhijit S. Nair .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

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)

Publish with us

Policies and ethics