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Mechanical Ventilation II: Invasive Ventilation

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
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Mechanical Ventilation III: Noninvasive Ventilation

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Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
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Mechanical Ventilation I: Indication and Settings

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Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...

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Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

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Updated: Jun 25, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

Autotitrating versus standard noninvasive ventilation: a randomised crossover trial.

J Jaye¹, M Chatwin, M Dayer

¹Sleep and Ventilation Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. j.jaye@rbht.nhs.uk

The European Respiratory Journal

|March 3, 2009

Summary

Automatic titration of noninvasive ventilation (NIV) offers comparable nocturnal oxygenation to standard NIV for patients with neuromuscular disorders. While sleep quality is maintained, autotitrating NIV showed a slight increase in carbon dioxide levels.

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Area of Science:

Respiratory Medicine
Sleep Medicine
Biomedical Engineering

Background:

Noninvasive ventilation (NIV) is crucial for managing nocturnal hypoventilation in neuromuscular and chest wall disorders.
Long-term ventilatory support requires effective and patient-friendly management strategies.

Purpose of the Study:

To compare the efficacy of autotitrating NIV with conventional NIV in patients with stable neuromuscular and chest wall disorders on long-term ventilatory support.
To evaluate the impact of autotitrating NIV on nocturnal gas exchange and sleep quality.

Main Methods:

A randomized crossover trial involving 20 patients with neuromuscular/chest wall disorders requiring long-term NIV.
Comparison between a standard bilevel ventilator (VPAP III) and an autotitrating bilevel ventilator (AutoVPAP).
Assessment included overnight polysomnography and Holter monitoring after 1-month treatment periods.

Main Results:

Nocturnal oxygenation was comparable between autotitrating and standard NIV.
Sleep efficiency, arousals, and heart rate variability showed no significant differences.
Autotitrating NIV resulted in a small but significant increase in overnight transcutaneous carbon dioxide tension and a decrease in stage 1 sleep.

Conclusions:

Autotitrating noninvasive ventilation (AutoVPAP) provides comparable nocturnal oxygenation control to standard NIV.
Autotitrating NIV does not compromise sleep quality in stable patients with neuromuscular and chest wall diseases.
Further monitoring of carbon dioxide levels may be warranted with autotitrating NIV in this patient population.