Non-Invasive Ventilation
Non-invasive ventilation delivers pressurised air through a mask, supporting breathing without a tube and without sedation. Patients stay awake and can be taken off it to eat and speak. For many, particularly in COPD, it removes the need for intubation entirely.
- No breathing tube and no sedation
- Patients stay awake and can speak
- Removed for meals and medication
- Avoids intubation in many patients
Stay
Hours to days
Duration
Used in sessions or continuously
Anaesthesia
None, the patient stays awake
About Non-Invasive Ventilation
The mask fits tightly over the nose or the nose and mouth, and the machine delivers pressure that supports each breath. It works best in COPD with rising carbon dioxide and in fluid on the lungs from heart failure. It is uncomfortable at first, and tolerance improves considerably with coaching in the first hour, which is where most of the nursing effort goes.
- Works best in COPD and in heart failure with fluid on the lungs
- The first hour decides whether a patient tolerates it
- Removed periodically for eating and speaking
- Escalation to intubation is planned in advance, not improvised
Before you read on
Everything here is general information about non-invasive ventilation. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest non-invasive ventilation.
- COPD exacerbation with rising carbon dioxide
- Fluid on the lungs from heart failure
- Respiratory failure after surgery
- Breathing failure in neuromuscular disease
- Patients in whom intubation is to be avoided if possible
- Weaning support after removal of a breathing tube
Procedure details
The usual sequence, from first consultation through to follow-up.
Fitting the mask
The mask is sized and fitted, and the pressures set low at first. Someone stays with you while you get used to it.
Settling in
The first hour is the hardest. Pressures are increased gradually as you adjust, with coaching on breathing with the machine.
Monitoring
Blood gases are checked after the first hour or two to confirm it is working, and settings adjusted accordingly.
Weaning off
Time off the mask is increased as breathing improves, until it is needed only overnight and then not at all.
How to prepare
What to sort out before you come in.
- Bring any home CPAP or BiPAP machine and mask you already use
- Tell staff if you are claustrophobic, as this affects tolerance and can be helped
- Remove dentures if the mask does not seal around them
- Expect the first hour to be uncomfortable, as this is normal and improves
- Bring a list of inhalers and home oxygen settings
Recovery
What to expect afterwards, and roughly when.
- Most patients need it for hours to a few days
- Facial soreness where the mask sits is common and is managed with padding
- A dry mouth and nose are common and humidification helps
- Weaning is done by increasing time off the mask rather than stopping suddenly
- Some patients continue with a machine at home overnight, which is arranged before discharge
Why choose Humayun for non-invasive ventilation
Non-invasive ventilation succeeds or fails in the first hour, and that hour is about coaching rather than equipment.
- Someone stays with the patient through the first hour, which is what decides tolerance
- Blood gases checked early to confirm it is working rather than persisting with something that is not
- Clear plan for escalation to intubation agreed in advance rather than improvised
- Home machines arranged before discharge for patients who need ongoing support
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