Consensus Statements

Mechanical Ventilation: Beyond the ICU
Quick Reference Guide

TOC | Previous | Next

Delivery of NIV

For patients receiving NIV, efficacy of ventilation should be assessed at initial application and at follow-up, including measures of daytime gas exchange and nocturnal monitoring.

Noninvasive Positive Pressure Ventilation (NPPV): initially used most often nocturnally, with daytime use added per patient's needs; NPPV requires a positive pressure ventilator connected to a nasal interface or mask.

Negative Pressure Ventilation (NPV): applied via a body tank, chest cuirass, or body wrap, NPV can effectively augment ventilation in long-term support; however, NPV is currently reserved for patients in whom NPPV failed, or as an alternate supplementary form of support for patients using other means of ventilatory assistance.

Rocking Bed and Pneumobelt: both have limited utility but are particularly effective in patients with severe bilateral diaphragmatic weakness or paralysis; neither device is suitable in acute respiratory failure.

Diaphragm Pacing: electrical stimulation of the phrenic nerve to contract the diaphragm; presently best reserved for children with high spinal cord lesions or central hypoventilation; should be conducted in a medical center with experience in the technique.

Glossopharyngeal Breathing (GSB): gulping motions of the tongue to force air into the lungs; encouraged in appropriate patients to increase free time off the ventilator, to improve cough, and to increase the patient's perception of independence.

Noninvasive Aids To Clear Secretions: manually assisted coughing is recommended for patients with weakened expiratory muscles who also have excessive secretions.

 

TOC | Previous | Next

3300 Dundee Road • Northbrook, Illinois 60062-2348 • (847) 498-1400 • (800) 343-2227
Copyright ©1999-2008 American College of Chest Physicians. All Rights Reserved.
ACCP Privacy Policy | ACCP Web Site Terms of Use