CLINICAL OVERVIEW

Chronic Noninvasive Ventilation

This clinical overview equips health professionals with a practical understanding of chronic noninvasive ventilation (NIV) in adult patients. It begins by clarifying key terminology related to NIV and the various devices and modes used. The overview then delves into the background and indications for NIV, focusing on chronic alveolar hypoventilation (CAH) and its associated conditions like neuromuscular diseases, chest wall abnormalities, and sleep-disordered breathing. The article provides a detailed approach to patient assessment, including evaluation of symptoms, respiratory function, and inspiratory muscle strength. It offers step-by-step guidance on initiating NIV, covering patient and caregiver education, interface selection, and titration of ventilator settings. Importantly, the overview also addresses potential complications of NIV, such as patient-ventilator asynchrony and mask intolerance, and provides solutions for these challenges. Drug therapy options for managing associated symptoms like sialorrhea and anxiety are also explored. Finally, the overview discusses prognosis, follow-up monitoring, and special considerations for patients with obstructive sleep apnea and COPD, making it a comprehensive resource for clinicians managing patients on chronic NIV.