Noninvasive ventilation NIV

NIV has several advantageous features for weaning patients, including the absence of sedative drugs, early removal of the endotracheal tube, a decrease in ventilator associated pneumonia, and better compliance with chest physiotherapy.57 These advantages have seldom been studied in a controlled manner and to date the majority of studies have been performed in patients with chronic respiratory failure in an effort to avoid endotracheal intubation.

In 22 patients referred to a specialist chronic ventilation unit for weaning from mechanical ventilation, NIV was rapidly tolerated in 20 and many were extubated quickly.58 Ten patients required nasal ventilation at night when discharged home. Although this study was not controlled, it certainly shows that patients who are difficult to wean can be extubated and may be managed in a high dependency area using NIV support.

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