[Non-invasive Home-Ventilation: Pathophysiology, Initiation and Follow-up]
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Updated: Aug 21, 2025

Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
Jens Spiesshoefer, Jan Hendrik Storre1, Michael Dreher1
1Klinik für Pneumologie und Internistische Intensivmedizin; Uniklinik RWTH Aachen.
Abstract:
COPD is the most common reason for hypercapnia. However, it is - by far - not the only reason. In fact, numerous neuromuscular disorders (not only ALS) as well as restrictive thoracic disorders do also lead to clinically highly relevant hypercapnia. Early diagnosis of hypercapnic ventilatory failure usually takes place at nighttime. NIV devices work with a periodic interplay of alternating IPAP and EPAP which results in a ventilation of the lungs, thereby elimination CO2 to treat hypercapnic respiratory failure. Firstline settings for a NIV therapy to treat "stable hypercapnia" are as follows: Pressure Support Ventilation Modus, EPAP 5 cm H2O, IPAP 15 cm H2O, Back Up rate 15/Minute. The overall goal of NIV treatment is a successful reduction in CO2. This can be achieved by changing the following variables of the ventilator settings: increase in IPAP ± increase in back up respiratory rate ± use of assisted pressure controlled ventilation mode (APCV)-.
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