Noninvasive ventilation, better known as NIV, consists of a method to help a person breathe through devices that are not introduced into the respiratory system, as is the case with intubation that requires mechanical ventilation, also called breathing. by appliances. This method works by facilitating the entry of oxygen through the airways due to an air pressure, which is applied with the aid of a mask, which can be facial or nasal.
Generally, the pulmonologist recommends non-invasive ventilation for people who have chronic obstructive pulmonary disease, also called COPD, asthma, pulmonary edema due to heart problems and obstructive sleep apnea syndrome, the most common type being CPAP.
In cases where a person has difficulty breathing, with a drop in blood oxygen levels or does not breathe, non-invasive ventilation is not indicated, and other techniques should be performed to ensure more oxygen supply.
What is it for
Non-invasive ventilation serves to improve gas exchange, facilitating breathing through pressure that exerts on the opening of the airways and aiding in the movements of inspiration and expiration. This method can be indicated by a pulmonologist or general practitioner and is performed by a physiotherapist or nurse in people who have the following conditions:
- Respiratory failure; Chronic obstructive pulmonary disease; Pulmonary edema caused by heart problems; Asthma; Acute respiratory distress syndrome; Breathing difficulty in immunocompromised people.
Most of the time, non-invasive ventilation is used in conjunction with drug treatment and has the advantages of being a method that offers less risk of infection, does not require sedation and allows the person to speak, eat and cough during use of the mask. As it is easy to use, there are portable models that can be used at home, such as CPAP.
Main types
Non-invasive ventilation devices work as ventilators that release air, increasing the pressure in the airways, facilitating gas exchange and some models can be used at home. In general, these devices require specific regulation by physiotherapy and pressure is applied depending on each person's respiratory condition.
The types of devices used in non-invasive ventilation have several interfaces, that is, there are different masks so that the pressure of the device is applied over the airways, such as nasal, facial, helmet-type masks, which are placed directly in the mouth. Thus, the main types of NIV are:
1. CPAP
CPAP is the type of non-invasive ventilation that works by applying continuous pressure during breathing, this means that only one pressure level is used, and it is not possible to adjust the number of times the person will breathe.
This device can be used by people who have control over their breathing and is contraindicated for people who have neurological disorders or breathing problems that make breathing control difficult. CPAP is widely used for people with sleep apnea, as it allows the airways to remain open at all times, maintaining the passage of oxygen constantly during the period that the person is sleeping. Learn more about how to use and care for CPAP.
2. BiPAP
BiPAP, also called Bilevel or Positive Biphasic Pressure, favors breathing through the application of positive pressure on two levels, that is, it helps the person during the inspiration and expiration phase, and the respiratory rate can be controlled from a pre physiotherapist definition.
Furthermore, the pressure is triggered by the person's breathing effort and then, with the help of BiPAP, it is possible to maintain the breathing movements continuously, not allowing the person to go without breathing, being very indicated for cases of respiratory failure.
3. PAV and VAPS
PAV, known as Proportional Assisted Ventilation, is the type of device most used in hospitals in the ICU and works to adapt to the respiratory needs of the person, so the air flow, the respiratory rate and the pressure it exerts on the airways changes according to the person's effort to breathe.
VAPS, which is called Support Pressure with Guaranteed Volume, is the type of ventilator also used in hospitals, which works from the pressure regulation by a doctor or physiotherapy, according to the person's need. Although it can be used in non-invasive ventilation, this device is more used to control the breathing of people in invasive ventilation, that is, intubated.
When not indicated
Noninvasive ventilation is contraindicated in cases where the person has conditions such as cardiopulmonary arrest, loss of consciousness, after surgery on the face, trauma and burns on the face, airway obstruction.
In addition, care must be taken to use this method in pregnant women, and people who are undergoing tube feeding, with morbid obesity, anxiety, agitation and claustrophobia, which is when a person has the feeling of being trapped and the inability to stay indoors. Find out more about how claustrophobia is treated.
