Teaching Pearls in Noninvasive Mechanical Ventilation: Key Practical Insights

Preface
Contents
Abbreviations
List of Videos
Part I: Clinical Cases in Noninvasive Ventilation: Interfaces, Methodology
	Chapter 1: Facemask and Total Face Mask
		1.1 Introduction
		1.2 NIV-Mask
			1.2.1 Caratheristics
		1.3 Bronchopulmonary Displasia
		References
	Chapter 2: Helmet
		2.1 Introduction
		2.2 Helmet Interface
		2.3 Bronchiolitis
		References
	Chapter 3: Mouthpiece Ventilation
		3.1 Introduction
		3.2 Types of Mouth Piece Interfaces
		3.3 Indications
		3.4 Mechanisms
		3.5 Advantages
		3.6 Disadvantages and Contraindications
		3.7 Conclusions
		References
	Chapter 4: Discomfort and Adaptation in Non Invasive Mechanical Ventilation: Mask Interface Problems
		4.1 Choosing the Interface
		4.2 Problems Related to the Interface [2, 3]
		References
	Chapter 5: Discomfort and Adaptation. Mask Interface Problems
		5.1 Principles of Management
			5.1.1 Introduction
		5.2 Interface Selection
		5.3 Types of Interfaces
		5.4 Mask Interface Problems and Solutions
			5.4.1 Mask Claustrophobia
			5.4.2 Aerophagia
			5.4.3 Sore Nose, Skin Irritation and Ulcers
			5.4.4 Air leaks
			5.4.5 Carbon Dioxide Rebreathing
			5.4.6 Nasal or Oral Dryness and Nasal Congestion
			5.4.7 Eye Irritation
			5.4.8 Noise
		References
	Chapter 6: Unusual Facial Muscle Atrophy Associated with Noninvasive Ventilation
		6.1 Introduction
		6.2 Clinical Case
		6.3 Discussion
		References
	Chapter 7: Noninvasive Ventilation: Continuous Positive Air Pressure Ventilation (CPAP) and Pressure Support Ventilation (PSV)
		7.1 Introduction
		7.2 Mechanical Ventilation in IPF: Basic Topics
		7.3 Non-invasive Ventilation (NIV)
			7.3.1 NIV Mode: PSV vs. CPAP
			7.3.2 NIV Interface: Helmet vs. Face—Mask
		7.4 Summary
		References
	Chapter 8: Continuous Positive Airway Pressure
		8.1 Introduction
		8.2 Indications
		8.3 Use of CPAP in the pulmonary Edema due to Congestive Heart Failure
		8.4 Use of CPAP in the Obesity-Hypoventilation Syndrome
		8.5 Use of CPAP in the Obstructive Sleep Apnea Syndrome
		8.6 Use of CPAP in the Perioperative Period
		8.7 Contraindications
		References
	Chapter 9: How Do Hybrid Pressure Ventilation Modes Respond to Patient’s Varying Ventilatory Requirements? Insights from Respiratory Bench Simulations
		9.1 Introduction
		9.2 Volume-Assured Pressure Support (VAPS) Ventilation
		9.3 VAPS Ventilation with Autotitrating Expiratory Positive Airway Pressure (EPAP)
		References
Part II: Clinical Cases and Noninvasive Ventilation Physiology
	Chapter 10: Noninvasive Ventilation Extrapulmonary Response Determinants
		10.1 Introduction
		10.2 Effects of Positive Pressure Ventilation (PPV) on Thoracic Functions
		10.3 Increased Pulmonary Vascular Resistance and Altered Right and Left Ventricular Function
		10.4 The Effect of Positive Pressure Ventilation on Coronary Blood Flow
		10.5 Factors Determining Cardiovascular Effects of Positive Pressure Ventilation
		10.6 Indemnity in Individuals with Normal Cardiovascular Function
		10.7 Beneficial Effects of Positive Pressure Ventilation on Heart Function in Patients with Left Ventricular Dysfunction
		10.8 Effects of Mechanical Ventilation on Intracranial Pressure and Cerebral Perfusion
		10.9 Renal Effects of Mechanical Ventilation
		10.10 The Effect of Mechanical Ventilation on Liver and Gastrointestinal Functions
		10.11 Nutritional Problems During Mechanical Ventilation
		References
	Chapter 11: Patterns Response (Apnea, Hypopnea, Tachypnea)
		11.1 Introduction
		11.2 Types of Clinical Pattern Response
		References
	Chapter 12: Lung Mechanics- Compliance and Resistance-Extrapulmonary Response
		12.1 Introduction
		12.2 Resistance
			12.2.1 Tissue Resistance
			12.2.2 Airway Resistance
		12.3 Compliance
			12.3.1 Chest Wall Compliance
		12.4 Lung Compliance
		12.5 Clinical Vignette
		References
Part III: Clinical Cases and Noninvasive Ventilation Pattern Response
	Chapter 13: Early and Late Failure During Noninvasive Ventilation
		13.1 Introduction
		13.2 Discussion
		References
	Chapter 14: Noninvasive Ventilation. Rebreathing
		14.1 Introduction
		14.2 Discussion
		References
	Chapter 15: Bilateral Pneumothorax in Neuromuscular Disease Associated with Noninvasive Ventilation and Mechanical Insufflation-Exsufflation
		15.1 Introduction
		15.2 Discussion
		References
	Chapter 16: Early and Late Failure During Noninvasive Ventilation
		16.1 Introduction
		16.2 Immediate Failure
			16.2.1 Should These Patients Receive a Trial of NIV?
			16.2.2 Initiating NIV: Location
			16.2.3 Initiating NIV: Settings and Interface
		16.3 Early Failure
		16.4 Late Failure
		16.5 Predictive Scores
		16.6 Discussion and Practical Implications
		References
Part IV: Noninvasive Ventilation Interaction, Monitoring and Methodology
	Chapter 17: Patient Ventilator Asynchrony
		17.1 Trigger Asynchrony
		17.2 Flow Asynchrony
		17.3 Cycle Asynchrony
		References
	Chapter 18: Patient Ventilator Asynchrony
		18.1 Introduction
		References
	Chapter 19: Clinical Cases in Non Invasive Ventilation: Pressure Waveform
		19.1 Clinical Cases in Non Invasive Ventilation: Pressure Waveform
			19.1.1 Standard Clinical Case
		19.2 Discussion
		References
	Chapter 20: Pressure Waveform. Clinical Interpretation - Acute Respiratory Failure in COPD
		20.1 Discussion
		20.2 Waveform Analysis
		20.3 Pressure Support Level
		20.4 Leaks
		20.5 Inspiratory Trigger
		20.6 Cycling from Inspiration to Expiration
		20.7 Expiratory Asynchrony
			20.7.1 Delayed Cycling
		20.8 Conclusion
		References
	Chapter 21: Intensive Care Unit Ventilators Some Aspects in Noninvasive Mechanical Ventilation
		21.1 Introduction
		21.2 Discussion
		References
Part V: Clinical Cases in Noninvasive Ventilation: NIV in Procedures Applications
	Chapter 22: Non Invasive Mechanical Ventilation and Echocardiographic
		22.1 Introduction
		References
	Chapter 23: Lung and Diaphragm Ultrasound for Monitoring Patient’s Ongoing Non-invasive Mechanical Ventilation
		23.1 Introduction
		23.2 Complementary Explorations
		23.3 Discussion
		References
	Chapter 24: Non Invasive Mechanical Ventilation and Bronchoscopy
		24.1 Introduction
		24.2 Conclusions
		References
	Chapter 25: Clinical Cases in Noninvasive Ventilation: NIV in Procedures Applications. Bronchoscopy
		25.1 Discussion
		References
Part VI: Clinical Conditions: Acute Hypoxemic Respiratory Failure
	Chapter 26: Noninvasive Ventilation in Hematology-Oncology Patients with Acute Respiratory Failure
		26.1 Introduction
		26.2 Noninvasive Ventilation
		26.3 High Flow Oxygen Therapy
		26.4 Conclusion
		References
	Chapter 27: Treatment of Acute Respiratory Failure in Patient with Congestive Heart Failure and Pneumonia
		27.1 Introduction
		References
	Chapter 28: Neurally Adjusted Ventilator (NAVA) Mode
		28.1 Introduction
		28.2 Clinical Course
			28.2.1 Indications and Contraindications of NAVA
			28.2.2 Patient Interfaces
			28.2.3 Placement of the NAVA-Catheter
			28.2.4 Initiation of NAVA
			28.2.5 Ventilator Settings: Adjusting and Maintaining NIV-NAVA
			28.2.6 Alternative Ways of Setting NIV-NAVA
			28.2.7 Subject Ventilator Asynchrony
			28.2.8 The Diagnostic Value of the EADi Signal
			28.2.9 Weaning with and from NAVA
		References
	Chapter 29: Non-invasive Mechanical Ventilation in Pneumonia
		29.1 Introduction
		29.2 Discussion
		References
	Chapter 30: Non Invasive Ventilation in High Risk Infections
		30.1 Introduction
		30.2 Discussion
		References
	Chapter 31: Clinical Conditions—Acute Hypoxemic Respiratory Failure: Non Invasive Ventilation in Pneumonia
		31.1 Introduction
		31.2 Acute Hypoxemic Respiratory Failure Due to Pneumonia and Non-invasive Ventilation
		References
	Chapter 32: Non Invasive Ventilation in Asthma Exacerbation
		32.1 Introduction
		32.2 Discussion
		References
	Chapter 33: Unusual Case of Acute Pulmonary Edema Treated by Non Invasive Ventilation: A 30 Years Ago “Cold Case”!
		33.1 Introduction
		33.2 Discussion
			33.2.1 Formation and Resolution of Edema
			33.2.2 Detection Methods
				33.2.2.1 Radiological Aspects
				33.2.2.2 Acid Base Findings
			33.2.3 Ventilatory Therapy
			33.2.4 Outcome
		33.3 Limits of the Present Contribution
		33.4 Conclusions
		References
	Chapter 34: Non Invasive Ventilation in Acute Cardiac Pulmonary Edema
		34.1 Introduction
		34.2 Physiopathology of Pulmonary Edema of Cardiogenic Origin and Effects of Positive Airway Pressures
		34.3 Respiratory Support in Acute Cardiac Pulmonary Edema
		34.4 Concluding Remarks
		Suggested Reading
	Chapter 35: Clinical Conditions Acute Hypoxemic Respiratory Failure: Non Invasive Ventilation in Thoracic Trauma
		References
	Chapter 36: Thoracic Surgery, a Clinical Case in Non-invasive Ventilation: Clinical Conditions in the Perioperative Period
		36.1 Introduction
		36.2 The Teaching Case
		36.3 Preoperative Phase
		36.4 Intraoperative Phase
		36.5 Postoperative Phase
		References
	Chapter 37: Non-invasive Ventilation Following Thoracotomy: Clinical Case
		37.1 Introduction
		37.2 Discussion
		References
	Chapter 38: Noninvasive Ventilation in Acute Respiratory Distress Syndrome
		References
	Chapter 39: Nasal High Flow Oxygen During Post-extubation Period in a Patient with Traumatic Brain Injury
		39.1 Introduction
		39.2 Conclusion
		References
Part VII: Clinical Conditions: Sleep Breathing Disorders
	Chapter 40: Treatment-Emergent Central Sleep Apnea: Always Look for an Air Leak
		40.1 Introduction
		40.2 Discussion
			40.2.1 Pathophysiology of TECSA
			40.2.2 Time-Course of TECSA
			40.2.3 Treatment
		References
	Chapter 41: Non Invasive Ventilation in Sleep Apnea Syndrome
		References
	Chapter 42: Nocturnal Hypoventilation and Sleep Breathing Disorders
		42.1 Definitions
		42.2 Pathophysiology of Hypoventilation During Sleep
		42.3 Clinical Presentation and Evaluation
		42.4 Classification and Causes of Sleep Related Hypoventilation
			42.4.1 OHS
			42.4.2 CCHS
			42.4.3 Late Onset Central Hypoventilation with Hypothalamic Dysfunction
			42.4.4 Neuromuscular Disorders
			42.4.5 Kyphoscoliosis
			42.4.6 Medication
			42.4.7 Heart Failure
		42.5 Treatment
		42.6 Discussion of Case
		References
	Chapter 43: Non Invasive Ventilation: Nocturnal Hypoventilation and Sleep Breathing Disorders
		43.1 Introduction
		43.2 Clinical Case of OHS Coexisting with OSA
			43.2.1 What Is the Diagnosis?
			43.2.2 What Is the Next Step?
			43.2.3 Which Is Better Therapy Option: CPAP or NPPV?
			43.2.4 What to Expect after Short-Term PAP Therapy Initiation?
			43.2.5 Lifestyle Changes—Weight Loss: Does it Matter?
		References
Part VIII: Clinical Conditions: Chronic Hypercapnic Respiratory Failure
	Chapter 44: Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease: Ventilating the Patient with Severe Respiratory Acidosis
		44.1 Introduction
		References
	Chapter 45: Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease
		45.1 Introduction
		45.2 Discussion
		References
	Chapter 46: Non-invasive Ventilation in Adults with Cystic Fibrosis
		46.1 Introduction
		46.2 Discussion
			46.2.1 Indications
				46.2.1.1 Chest Physiotherapy
				46.2.1.2 Hypoxia
				46.2.1.3 Nocturnal Desaturation and Hypoventilation
				46.2.1.4 Acute and Chronic Hypercapnic Respiratory Failure
			46.2.2 Contraindications and Complications of NIV in CF
			46.2.3 Starting NIV in CF
				46.2.3.1 General Considerations
				46.2.3.2 Chest Physiotherapy
				46.2.3.3 Hypoventilation and Respiratory Failure
		46.3 Conclusion
		References
	Chapter 47: Non Invasive Mechanical Ventilation in Idiopathic Pulmonary Fibrosis: A Clinical Case
		47.1 Introduction
		47.2 Discussion
		47.3 Non-invasive Mechanical Ventilation in IPF
		47.4 Indication to Start MV in IPF
		47.5 Modes of MV
		47.6 Interfaces: Helmet vs. Facial Mask
		47.7 Predictors of MV Failure in IPF
		47.8 Conclusions
		References
	Chapter 48: Non Invasive Ventilation, Pulmonary Rehabilitation and Chest Physiotherapy-1
		48.1 Introduction
		48.2 Discussion
		References
	Chapter 49: Non Invasive Ventilation, Pulmonary Rehabilitation and Chest Physiotherapy-2
		49.1 Brief Introduction to the Concept of Pulmonary Rehabilitation
		49.2 Noninvasive Ventilation: Why to Think About It?
		49.3 Types of NIV Useful in Association with Pulmonary Rehabilitation
			49.3.1 Negative Airway Pressure Devices
			49.3.2 Positive Airway Pressure Devices
			49.3.3 Non-invasive Ventilation as an Adjunct to Pulmonary Rehabilitation
			49.3.4 Pulmonary Rehabilitation and Noninvasive Ventilation in Acute Exacerbation of COPD
			49.3.5 Pulmonary Rehabilitation and Noninvasive Ventilation in Stable COPD Patients
			49.3.6 Pulmonary Rehabilitation and Noninvasive Ventilation at Home
			49.3.7 Pulmonary Rehabilitation and Noninvasive Ventilation in Palliative Care Services
		49.4 Conclusions
		References
	Chapter 50: Obesity Hypoventilation Syndrome
		50.1 Definitions
		50.2 Epidemiology
		50.3 Pathophysiology
		50.4 Clinical Presentation and Diagnosis
		50.5 Comorbidities
		50.6 Treatment
		50.7 Discussion of Case
		References
	Chapter 51: Elderly Non Invasive Mechanical Ventilation Applications
		51.1 Introduction
		51.2 Acute Respiratory Failure
		51.3 Acute Cardiogenic Pulmonary Edema
		51.4 Immunocompromised Elderly Patients
		51.5 Palliative Care and DNI
		51.6 Weaning
		51.7 Home NIV in Elderly Patients
		References
	Chapter 52: Elderly-NIV: Non-invasive Mechanical Ventilation Treatment in Elderly Patient with Usual Interstitial Pneumonia
		52.1 Real Case Clinic
			52.1.1 Introduction
			52.1.2 Complementary Explorations
			52.1.3 Discussion
		References
	Chapter 53: Clinical Case in Non Invasive Ventilation in End of Life
		53.1 Introduction
		53.2 An Ill Cancer Patient Who Has Chosen NIV
		53.3 Discussion
		53.4 Conclusion
		References
	Chapter 54: Clinical Cases in Non Invasive Ventilation: Home Mechanical Ventilation
		54.1 Introduction
		54.2 Neuromuscular Diseases
		54.3 Chest Wall Diseases
		54.4 Chronic Obstructive Pulmonary Disease
		54.5 Post-acute Exacerbation of COPD
		54.6 COPD-OSA Overlap Syndrome
		54.7 NIV in Bronchiectasis
		54.8 NIV in Cystic Fibrosis
		54.9 NIV in Obesity Hypoventilation
		54.10 Palliative NIV
		54.11 Ventilator Settings and Compliance
		54.12 Selection of Interface
		54.13 Conclusion
		References
	Chapter 55: Comorbidities Conditions Impact (Renal Failure/Liver Failure/Neurologic) in Non Invasive Mechanical Ventilation
		55.1 Introduction
		55.2 Discussion
		References
	Chapter 56: Clinical Cases in Noninvasive Ventilation: Clinical Conditions—Hypercapnic Failure—Neuromuscular Disorders
		56.1 Introduction
		56.2 Discussion
		References
	Chapter 57: Clinical Case in Noninvasive Ventilation: Clinical Conditions—Respiratory Care of Neuromuscular Disorders—A Rare Case of Charcot-Marie-Tooth Disease (CMT2S)
		57.1 Introduction
		57.2 Discussion Based on Case Clinic
			57.2.1 Development and Progress
			57.2.2 Acute Deterioration of the Patient at 9 Years
			57.2.3 Best Clinical Practice Statement from the Recommendations of British Thoracic Society Guidelines [4]
				57.2.3.1 Respiratory Management
				57.2.3.2 Airway and Secretion Management
			57.2.4 Nutrition
			57.2.5 Orthotics
		57.3 Summary
		References
	Chapter 58: Clinical Case in Noninvasive Ventilation: Clinical Conditions—Hypercapnic Failure—Neuromuscular Disorders in Amyotrophic Lateral Sclerosis
		58.1 Introduction
		58.2 Discussion/Main Topic
		References
	Chapter 59: Noninvasive Ventilation in Ventilatory Pump Failure: When Is Oxygen Administration Deadly?
		59.1 Clinical Practice
		References
	Chapter 60: Clinical Case in Non Invasive Ventilation: Ethical Aspects of the Palliative Use
		60.1 Introduction
		60.2 Discussion
		60.3 Conclusion
		References
	Chapter 61: Clinical Cases in Noninvasive Ventilation in Quality of Life
		61.1 Introduction
		61.2 MRF
		61.3 SRI
		61.4 S3-NIV Questionnaire
		61.5 HRQL Scores in Patients Receiving the NIV: Clinical Cases
		61.6 Conclusion
		References
	Chapter 62: Pediatric Non-invasive Ventilation: Non-invasive Ventilation Treatment in a Pediatric Patient with Catathrenia
		62.1 Introduction
		62.2 Video-PSG Sleep Study Data
		62.3 Discussion
		References