Replay - Non-Invasive Ventilation: Challenges and Successes

Non-invasive respiratory support is a proven intervention for patients with acute hypoxemic respiratory failure (1). However, not all patients are successfully managed with non-invasive support modalities (2) and there are several factors that may lead to a patient requiring intubation and invasive mechanical ventilation (IMV).

Non-invasive respiratory support does have other advantages, including that it may be used successfully as weaning tool for patients receiving invasive mechanical ventilation (3).

In this lecture Cesare Gregoretti M.D. & Nicholas Hill M.D., will discuss:

• Challenges with non-invasive respiratory supports (NRS) and reasons why NRS fails

• Predictors of failure and indications for invasive mechanical ventilation

• Non-invasive respiratory supports as a weaning tool

• Complications of delayed weaning from respiratory support

References:

1. Weerakkody S, Arina P, Glenister J, Cottrell S, Boscaini-Gilroy G, Singer M, Montgomery HE. Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research. Lancet Respir Med. 2022 Feb;10(2):199-213. doi: 10.1016/S2213-2600(21)00414-8. Epub 2021 Nov 9. Erratum in: Lancet Respir Med. 2021 Dec;9(12):e114. PMID: 34767767; PMCID: PMC8577844.

2. Strickland SL. The Patient Experience During Noninvasive Respiratory Support. Respir Care. 2019 Jun;64(6):689-700. doi: 10.4187/respcare.06642. PMID: 31110037.

3. Yeung J, Couper K, Ryan EG, Gates S, Hart N, Perkins GD. Non-invasive ventilation as a strategy for weaning from invasive mechanical ventilation: a systematic review and Bayesian meta-analysis. Intensive Care Med. 2018 Dec;44(12):2192-2204. doi: 10.1007/s00134-018-5434-z. Epub 2018 Oct 31. PMID: 30382306; PMCID: PMC6280833.