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Noninvasive Ventilation
Mukesh Kumar Agarwal
CHAPTER 1:
HISTORICAL ASPECT
PURPOSE OF TEXT
Clinical Pearl
In a Nutshell
CHAPTER 2:
INTRODUCTION
PURPOSE OF TEXT
Physiological Effects of NIV (Table 2.1)
Aims of NIV
Prerequisites for Noninvasive Ventilation
Related to Patient
Related to Hospital
Related to Equipment
Related to Disease
Complications of Invasive Mechanical Ventilation (Fig. 2.2)
Clinical Pearls
In a Nutshell
CHAPTER 3:
HOW NONINVASIVE VENTILATION WORKS
PURPOSE OF TEXT
Clinical Pearl
In a Nutshell
CHAPTER 4:
INDICATIONS OF NONINVASIVE VENTILATION
PURPOSE OF TEXT
Window of Opportunity
Successful Start is indicated by:
Clinical Pearl
In A Nutshell
CHAPTER 5:
CONTRA- INDICATIONS OF NONINVASIVE VENTILATION
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 6:
KEY TO SUCCESS
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 7:
TYPES OF NONINVASIVE VENTILATION (NIV)
PURPOSE OF TEXT
Noninvasive Ventilation can be Applied to Patients in Two Ways
Negative Pressure Noninvasive ventilation
Positive Pressure Noninvasive Ventilation
Clinical Pearl
In a Nutshell
CHAPTER 8:
MODES OF NONINVASIVE VENTILATION
PURPOSE OF TEXT
Bi-level Ventilation
Spontaneous Mode
Spontaneous/Timed Mode
Timed Mode
CPAP Mode
Choosing Modes on Bi level Ventilation
Clinical Pearls
In a Nutshell
CHAPTER 9:
EQUIPMENT OF NIV: VENTILATO R
PURPOSE OF TEXT
Components of NIV
Equipment of NIV Consists of:
Bi PAP ventilator
Clinical Pearls
In a Nutshell
CHAPTER 10:
EQUIPMENT OF NIV: INTERFACE AND ACCESSORIES
PURPOSE OF TEXT
Definition
Types of Interface
Material of Interface
Age of Interface
Spacers
Head Gear
Ideal Interface
Use of Interface
Comparison of Nasal Mask and Full Face Mask
Complications of Interface (Nasal or Full Face Mask)
Clinical Pearls
In a Nutshell
CHAPTER 11:
CARE OF NIV EQUIPMENT
PURPOSE OF TEXT
Care of Ventilator
Care of Interface
Care of Accessories
Clinical Pearl
In a Nutshell
CHAPTER 12:
IPAP, EPAP AND CPAP
PURPOSE OF TEXT
IPAP
EPAP
CPAP
Functions of IPAP, EPAP and CPAP (Fig. 12.1)
Function of IPAP
Function of EPAP
Function of CPAP
BI LEVEL POSITIVE AIRWAY PRESSURE VENTILLATION (Bi PAP VENTILLATION)
Optimal or Ideal IPAP
Optimal or Ideal EPAP
OPTIMAL CPAP
Pressure Support
Example
Obstructive Sleep Apnea (OSA)
Apnea-Hypopnea index (AHI)
Clinical Pearls
In a Nutshell
CHAPTER 13:
STARTING NIV
PURPOSE OF TEXT
Titration of IPAP and EPAP
Initial Monitoring after Starting NIV
Leak during NIV
Causes of Leak during NIV
Complications of Leak
Supplemental Oxygen during NIV
Technique of giving Supplemental Oxygen
Synchronization
Humidification in NIV
Clinical Pearls
In a Nutshell
CHAPTER 14:
MONITORING DURING NIV
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 15:
WEANING FROM NIV
PURPOSE OF TEXT
Goal of Weaning
Remember while Weaning
Place of Weaning
Causes of Weaning Failure
Successful Completion of NIV
Clinical Pearls
In a Nutshell
CHAPTER 16:
ADVANTAGES, DISADVANTAGES AND COMPLICATIONS OF NONINVASIVE VENTILATION
PURPOSE OF TEXT
Advantages of Noninvasive Ventilation (Fig. 16.1)
Disadvantages of Noninvasive Ventilation
Complications of NIV
Clinical Pearls
In a Nutshell
CHAPTER 17:
EFFICACY OF NIV
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 18:
FAILURE OF NIV
PURPOSE OF TEXT
Causes of NIV Failure
Diagnosis of NIV Failure
Clinical Pearl
In a Nutshell
CHAPTER 19:
NIV AS A WEANING MODE
PURPOSE OF TEXT
Candidates for NIV as a Weaning Mode
Prerequisites for using NIV as a Weaning Mode
ADVANTAGES OF NIV AS A WEANING MODE
Goal of Weaning
How to use NIV as a Weaning Mode from Invasive Mechanical Ventilation?
Equipment
Settings
Some Commonly Used Methods of Weaning
Causes of Weaning Failure
Clinical Pearls
In a Nutshell
CHAPTER 20:
NIV IN SPECIAL SITUATIONS
PURPOSE OF TEXT
Noninvasive Ventilation in COPD
NEED OF VENTILATORY SUPPORT IN COPD
Timings of NIV in COPD
Uses of NIV in COPD
NIV IN CARDIOGENIC PULMONARY EDEMA
Physiological Changes in Cardiogenic Pulmonary Edema
Choice of Equipment
Settings
Other Considerations
Efficacy of NIV in Cardiogenic Pulmonary Edema
CLINICAL PEARLS
In a Nutshell
CHAPTER 21:
NIV IN NEUROMUSCULAR DISEASES
PURPOSE OF TEXT
Muscles of Respiration
Cough Reflex
Prerequisites of Effective Cough Reflex
Causes of Impaired Cough Reflex
Causes of Weak Cough Reflex in Neuromuscular Diseases
Technique of NIV in Neuromuscular Patients
Timings of Ventilatory Support
Limitations of NIV in Neuromuscular Diseases
Clinical Pearls
In a Nutshell
CHAPTER 22:
NIV AT HOME
PURPOSE OF TEXT
Advantages of Home NIV Therapy
Aims of Home NIV Therapy
Indications of Home NIV Therapy
Prerequisites for Home NIV Therapy
Timing of NIV
Noninvasive home ventilation can be given:
Ideal Home NIV Apparatus
Popularity of Home NIV
Clinical Pearl
In a Nutshell
CHAPTER 23:
NIV IN CHILDREN
PURPOSE OF TEXT
Indications of NIV in Children
How to Start NIV in Children?
Clinical Pearls
In a Nutshell
CHAPTER 24:
LONG-TERM NONINVASIVE VENTILATION
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 25:
PROBLEMS IN NIV
PURPOSE OF TEXT
Clinical Pearls
In a Nutshell
CHAPTER 26:
SELECTION OF BEST NONINVASIVE EQUIPMENT AND NIV SETUP
PURPOSE OF TEXT
Spectrum of Noninvasive Ventilation Equipment
Choice of Noninvasive Ventilator
Deciding Best Equipment
Setting of Noninvasive Ventilation Unit
Clinical Pearl
In a Nutshell
CHAPTER 27:
RESPIRATO RY FAILURE
PURPOSE OF TEXT
Type 1 Respiratory Failure
Type 2 Respiratory Failure
Ventilation Perfusion Mismatching
Cinical Picture
Diagnosis of Respiratory Failure
Treatment of Respiratory Failure
NIV in Respiratory Failure
Clinical Pearls
In a Nutshell
CHAPTER 28:
ABG IN A NUTSHELL
PURPOSE OF TEXT
Pulmonary Shunt or Venous Admixture
Compensation
Definition of Useful Terms
Steps of Arterial Blood Gases (ABG) Interpretation
Clinical Pearls
In a Nuttshell
CHAPTER 29:
SELF-ASSESSMENT QUIZ AND INTERESTING CLINICAL SITUATIONS
CHAPTER 30:
GENERAL CONSIDERATIONS
PURPOSE OF TEXT
Aims of Ventilation
Components of Ventilation
Respiratory Muscle Weakness
Causes of Respiratory Muscle Weakness
Tidal Percussion (Fig. 30.4)
Signs of Efficient Ventilation
Consequences of Increased Work of Breathing
Causes of Respiratory Muscle Load
Causes of Decreased Central Drive
Components of Respiratory Muscle Training (Fig. 30.5)
Components of Efficient Ventilation
Respiratory Muscle Fatigue and Respiratory Muscle Weakness
Respiratory Muscle Weakness is of Two Types
Respiratory Muscle Strength
Respiratory Muscle Endurance
Signs of Respiratory Muscle Fatigue (Figs 30.7 and 30.8)
Work of Breathing
Aims of Ventilatory Support
Receptors of Lung
Clinical Pearl
In a Nutshell
ANNEXURE:
Equipment of NIV-Ventilator, Interface and Acessories
INDEX
TOC
Index
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