8 results
Noninvasive Positive Pressure Ventilation (NIPPV)

Expiratory & Inspiratory Positive Airway Pressure
Both increase intrathoracic pressure, which can decrease
Pressure Ventilation (NIPPV ... mortality, LOS NIPPV ... acute respiratory failure ... Chronic respiratory failure ... WOB, dyspnea NIPPV
Non-Invasive Positive Pressure Ventilation
Indications: 
 • COPD exacerbation (↓ intubation, ↓ mortality), Cardiogenic pulmonary edema (↓
of respiratory failure ... Extubation to NIPPV ... Nasal Modes: • CPAP ... Spontaneous Time (a.k.a BiLevel ... , BiPAP) • AVAPS
A Non-Invasive approach to Respiratory Failure
 • COPD and Ventilatory Failure → NiPPV with Bi-level Settings
to Respiratory Failure ... and Ventilatory Failure ... → NiPPV with Bi-level ... Pulmonary Edema → NiPPV ... CPAP or Bi-level
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
pneumonia vs. heart failure ... -BiPAP should never ... #BiLevel #HFNC ... #HighFlow #NIPPV ... RespiratorySupport #Selection #Algorithm
COVID-19 Hypoxia Management

Indication for endotracheal intubation?
Tolerating supplemental oxygen?
Consider HFNC
Not tolerating HFNC or HFNC is not available?
Consider
CONSIDER: a trial of NIPPV ... criticalcare #hypoxia #failure ... #algorithm #survivingsepsis
BiPAP Initiation Algorithm
Screen for contraindications:
 • Obtundation (unarousable)
 • Inability to wear a mask (wounds)
 •
BiPAP Initiation ... Algorithm Screen ... amzn.to/3rEtbK8 #BiPAP ... #BiLevel #Initiation ... #Algorithm #management
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
the flow rate) CPAP ... • Titrate CPAP ... criticalcare #hypoxia #failure ... #algorithm
Hepatocellular Liver Injury - Differential Diagnosis Framework:
Liver Injury → liver test abnormalities without evidence of liver
evidence of liver failure ... • Medications (APAP ... Diagnosis #hepatology #algorithm