Indications and Contraindications for NIPPV

Indications and Contraindications for NIPPV

Indications:

NIPPV is primarily indicated for the early rescue of mild-moderate respiratory failure; it can also be used for invasive-noninvasive ventilation sequential therapy and assisted withdrawal.

Its reference indications are

(1) The patient’s condition: (i) conscious; (ii) able to remove airway secretions independently; (iii) shortness of breath (frequency >25 times min), assisted respiratory muscles involved in respiratory movement.

(2) Blood gas indicators, sea level breathing room air, arterial partial pressure of oxygen (PaO2) <60mm.

(PaO2)<60mmHg (1mmHg=0.133kPa) with or without carbon dioxide partial pressure (PaCO2)>45mmHg (1mmHg=0.133kPa)

(PaCO2) >45mmHg.

Absolute contraindication:

Cardiac arrest or respiratory arrest (weak), which requires immediate life support such as cardiopulmonary resuscitation and tracheal intubation.

Relative contraindications:

① impaired consciousness; ② inability to autonomously remove airway secretions, risk of aspiration; ③ severe upper gastrointestinal bleeding; ④ hemodynamic instability; ⑤ upper respiratory tract obstruction; ⑥ undrained pneumothorax or mediastinal emphysema; ⑦ inability to wear a face mask such as facial trauma or deformity; ⑧ patients do not cooperate.

The application of NIPPV in patients with relative contraindications requires comprehensive consideration of the patient’s situation and weighing the pros and cons before making decisions, otherwise it increases the risk of failure of NIPPV treatment or may lead to patient injury.

Why Choose The Air ICU Series?

Experiments have demonstrated that the mesh nebulizer is currently the most ideal nebulizing device for delivering inhaled preparations for use in conjunction with a ventilator.

Compared to compression nebulizers, mesh nebulizers have a higher delivery efficiency than compression nebulizers when used in conjunction with a ventilator [1].

Compared to ultrasonic nebulizers, ultrasonic nebulizers have been used less frequently in clinical practice due to the inability to nebulize viscous solutions, the potential for the heat generated to destroy the solution, and larger residues [2].

Compared to pMDI and due to difficulty in synchronizing inhalation, pMDI reduces drug delivery and drug dose may change due to separation from the ejection agent [3].

Air ICU is a new generation of professional mesh nebulizer with feellife core patents.

It is embedded with AiMesh®inside polymer diaphragm technology and breath sensing technology.

[1] Berlinski A and Willis JR. Albuterol delivery by 4 different nebulizers placed in 4 different positionsin a pediatric ventilator in vitro model. Respiratory care.2013,58:1124-33.

[2] Ari A and Fink JB. Guidelines for aerosol devices in infants, children and adults: which to choose, why and how to achieve effective aerosol therapy. Expert review of respiratory medicine.2011;5:561-72.

[3] Diot P, Morra Land Smaldone GC. Albuterol delivery in a model of mechanical ventilation. Comparison of metered-dose inhaler and nebulizer efficiency. American journal of respiratory and critical care medicine.1995;152:1391-4.