NIPPV Flashcards
When would you use NIPPV?
Anything w/high WOB
- CHF
- Asthma
- COPD
- Bad response to extubating
What 2 things should you monitor from the PT for NIPPV?
- WOB; think about their RR
- don’t wait for resp. failure - CNS status
How do you prevent intubation?
- Treat underlying cause, but focus on protecting resp. drive
- Maintain fluid balance
- Antibiotics if needed
What are prosts upper limits?
16/4; pressure support upper limit is 12.
- remember the delta is more important when setting ipap/epap.
How often should you titrate changes for NIPPV?
3-5 minutes
What physiological effects does IPAP have?
- Reduces WOB
- Relives resp. muscle fatigue.
- Augments pts own spont. efforts -> Improves Vt
Does IPAP or EPAP improve oxygenation?
EPAP; it helps maintain the airway open and improves oxygenation by preventing airway collapse during exhalation.
Does IPAP or EPAP improve ventilation?
IPAP; it increases the patients tidal volume by providing PPV during inspiration.
- helps overcome resistances in airways and improves the dist. of air throughout the lungs.
When looking at the Pt. what are things you can observe as indications for NPPV?
- Accessory muscle use.
- Paradoxical breathing
- Resp rate > 25
- Dyspnea.
- PaCO2 > 45 w/pH < 7.35
- P/F ratio < 200
What are the goals for NPPV?
- Improve acidosis
- Improve resp. rate and HR
When should you terminate NPPV and move on to Mech. ventilation?
- worsening pH and CO2
- RR > 30 bpm
- Hemodynamic instability
- Inability to clear secretions
- Decreased LOC
What would you normally set the pt on for NPPV?
- CPAP
- [S] Spontaneous mode
- [S/T] spontaneous/timed mode
- [T] Timed mode.
BIPAP is a general name used for NPPV, what do we know it as?
Pressure support
Does CPAP augment ventilation?
No. the breaths are spontaneous unsupported breaths (pt in full control)
What are the following criteria for NIPPV?
1. Trigger
2. Limit
3. Cycle
- Pt. triggered
- Pressure limited
- flow cycled
