Non-invasive respiratory support : a practical handbook by Anita K. Simonds

By Anita K. Simonds

A hugely informative guide, giving transparent and consumer pleasant suggestion at the useful points of non-invasive respiration help, together with how you can pick out sufferers, decide on apparatus and start up therapy.

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Non-invasive respiratory support : a practical handbook

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In addition FEV1 improved, which has not been seen in other COPD studies, and the pressures were well tolerated. This work is limited by the fact that there is no information on sleep quality and exacerbation rates. The authors point out that targeting ventilator NON-INVASIVE POSITIVE PRESSURE INTERFACES 21 settings to maximize improvement in CO2 and continued adjustment to optimize this is helpful. 9) hospital days was required to establish best settings. An overview of studies in COPD suggests a north/south divide in that higher IPAP levels are often used in northern Europe (Germany, UK) and lower values in southern Europe, whereas controlled mode tends to be favoured in Germany.

As expected, nasal masks predominate in long-term use (73 per cent), with 11 per cent using nasal plugs, 6 per cent facial masks and 5 per cent oral interfaces. The main factors in choosing the right interface are: • • • • • To have as wide as possible variety of interfaces in different sizes available Attention to fitting correctly Comfort of mask and headgear Minimize leak from mouth and around mask Minimize deadspace. NON-INVASIVE POSITIVE PRESSURE INTERFACES 25 There is good evidence that leaks not only reduce efficiency of ventilation, but also impair sleep quality.

6. Corrado A, Roussos C, Ambrosino N et al. Respiratory intermediate care units: a European survey. Eur Respir J 2002; 20: 1343–1350. 7. Carlucci A, Delmastro M, Rubini F, Fracchia C and Nava S. Changes in the practice of non-invasive ventilation in treating COPD patients over 8 years. Intensive Care Med 2003; 29: 419–425. 8. British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax 2002; 57: 192–211. 9. Sinuff TCDJ, Randall J and Allen CJ.

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