SAQ 88 – Respiratory – non-invasive ventilation and BiPAP

Question 3. non-invasive ventilation and BiPAP.

a. High-evidence indications

• Acute pulmonary oedema.
• COPD with acute ventilatory failure.
• Respiratory failure in immunosuppressed patients.

b. Lower-evidence indications

• Pneumonia.
• ARDS.
• Asthma.
• Children.
• Preoxygenation before intubation.

c. BiPAP benefits in COPD

• Inspiratory pressure support reduces work of breathing.
• Increases end-inspiratory volume.
• Expiratory pressure reduces alveolar collapse during expiration.
• Improves time for gas exchange and arterial oxygenation.
• Improves carbon dioxide elimination.
• Closed circuit allows controlled oxygen delivery.

d. Patient factors

• Spontaneously ventilating and able to trigger breaths.
• Alert enough to cooperate and tolerate the mask.