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Negative-pressure ventilation.

S Levine1, S Levy, D Henson

  • 1Medical College of Pennsylvania, Philadelphia.

Critical Care Clinics
|July 1, 1990
PubMed
Summary
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Non-invasive positive pressure ventilation (NIPPV) shows promise for treating hypoxemia in ARDS models and supporting adult patients with respiratory conditions. Further research is needed to establish its full potential and identify patient subsets for optimal use.

Area of Science:

  • Pulmonary Medicine
  • Critical Care
  • Respiratory Physiology

Background:

  • Non-invasive positive pressure ventilation (NIPPV) is an evolving field with various applications.
  • Understanding its efficacy and limitations in different patient populations is crucial for clinical practice.

Observation:

  • Canine models of ARDS suggest NIPPV with NEEP is comparable to PPV with PEEP for hypoxemia.
  • NIPPV with NEEP may offer a cardiac output advantage over PPV with PEEP.
  • Current neonatal use of NIPPV is limited, but it's effective for chronic support in adult neuromuscular and chest wall diseases.

Findings:

  • NIPPV shows potential for chronic intermittent therapy in specific Chronic Airflow Limitation (CAL) patient subsets, though criteria are not yet defined.
  • Nasal positive airway pressure (PPV) can elicit ventilatory muscle response (VMR), offering a new method to study COPD patient improvements.

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  • The efficacy of NIPPV in postoperative weaning requires further investigation.

    • Implications:

    • NIPPV warrants further investigation for ARDS treatment and chronic ventilatory support in adults.
    • Developing criteria for NIPPV in CAL patients could optimize therapy.
    • Nasal PPV provides a novel tool to validate the role of VMR in COPD treatment efficacy.