NIV Checklist

Contraindications

• Missing spontaneous breathing
• Gasping
• Obstructed airway
• Gastrointestinal bleeding
• Ileus
• Non-hypercapnic coma

Relative contraindications

• Hypercapnic coma
• Agitation
• Interface incompatibility/not tolerated by patient/anatomical difficulties
• Severe hypoxemia
• Severe acidosis (pH < 7,1)

Success criteria

• Dyspnea reduced
• Consciousness improved
• Breathing frequency reduced
• pCO2 reduced
• pH normalizing
• arterial SaO2 > 85%
• Heart frequency normalizing

Settings

• initial PEEP 5 - 8 mbar
  • Below 5: re-check indication
  • Increase up to 10 mbar, depending on need
• Pinsp below 20 - 25 mbar
• driving pressure < 15 mbar
• Tidal volume 6 - 8 ml/kg
  • Rule of thumb: 400 - 500 ml
  • Dyspnea might cause initial high volumes
• backup frequency 10 - 15
• fIO: aim for SpO2 >= 90 %, usually fIO 30-35 %
• I:E 1:2 to 1:25

Comments

No comments yet...