positive pressure ventilation dead space

Older modalities, such as continuous positive airway pressure (CPAP), as well as ones recently introduced into the market, have been successfully used in the setting of ARF.

The main modality is noninvasive pressure support ventilation (NIPSV). This technique has been demonstrated to efficiently improve acute respiratory failure (ARF), avoiding the complications associated with endotracheal intubation (EI) and conventional invasive mechanical ventilation (IMV), especially ventilator-associated pneumonia. Noninvasive ventilation (NIV) refers to the delivery of ventilatory support or positive pressure into the lungs without an invasive endotracheal airway, 1, 2 usually through a mask. This review essentially analyzes the evidence of benefits of NIV in different populations with acute respiratory failure and describes the main modalities, new devices, and some practical aspects of the use of this technique. The appropriate selection of patients and the adaptation to the technique are the keys to success. It is also used as a home care therapy in patients with chronic pulmonary or sleep disorders. NIV is currently used in a wide range of acute settings, such as critical care and emergency departments, hospital wards, palliative or pediatric units, and in pre-hospital care. Alternatively, it can also be used in the postoperative period and in cases of pneumonia and asthma or as a palliative treatment. In acute settings, NIV is currently the first-line treatment for moderate-to-severe chronic obstructive pulmonary disease exacerbation as well as for acute cardiogenic pulmonary edema and should be considered in immunocompromised patients with acute respiratory insufficiency, in difficult weaning, and in the prevention of postextubation failure.

Both techniques, and some others that have been recently introduced and which integrate some technological innovations, have extensively demonstrated a faster improvement of acute respiratory failure in different patient populations, avoiding endotracheal intubation and facilitating the release of conventional invasive mechanical ventilation.

The first technique was continuous positive airway pressure but, after the introduction of pressure support ventilation at the end of the 20th century, this became the main modality. After the institution of positive-pressure ventilation, the use of noninvasive ventilation (NIV) through an interface substantially increased.

Positive pressure ventilation dead space