NON INVASIVE VENTILATION IN ACUTE RESPIRATORY FAILURE

Patients presenting with acute respiratory failure frequently require some form of assisted ventilation. In the past, endotracheal intubation and mechanical ventilation were the only treatment of choice, but noninvasive methods of ventilatory assistance now seem a possible alternative technique in some situations in selected patients even in the emergency departmentThe use of NPPV has rapidly proliferated during the paste decade. Previously, body ventilators such as negative pressure devices were the main non invasive means of assisting ventilation. After the introduction of the nasal mask to treat obstructive sleep apnea during the mid-1980s and the subsequent development of nasal ventilation, NPPV became the ventilator mode of first choice to treat patients with chronic respiratory failure as well as acute respiratory failure and it can be used in hospital wards, in high dependency and intensive care units and in accident and emergency departments as well.The goals of using NPPV is to relieve symptoms, reduce work of breathing, improve stabilize gas exchange, optimize patient comfort, improve sleep duration and quality of life, avoid complications of mechanical ventilation use (such as infection, barotruma and difficult weaning).Application of NPPV requires Interfaces which are devices for connecting ventilator tubing to the face. These facilitate the delivery of sustained high flow positive air pressure. Currently available interfaces include nasal, oronasal masks (full face masks), mouth pieces, and helmet.