Differences in the Use of Invasive and Non-Invasive Ventilators

Differences in the Use of Invasive and Non-Invasive Ventilators

Non invasive positive pressure ventilation through a face mask (or nasal mask) is generally used for respiratory failure patients with mild airway lung function damage and clear consciousness. With the deepening of understanding of respiratory physiology and the improvement of ventilation equipment, the indications for non-invasive ventilation are expanding; Invasive ventilators that require the establishment of artificial airways are mainly used for patients with severe life-threatening respiratory failure.

In principle, non-invasive ventilators can be applied to various situations of respiratory failure. In the past, coma was considered an absolute contraindication of non-invasive ventilators. However, due to the high incidence of complications and difficulty in nursing with invasive ventilators, sometimes it should not be overly pursued. For example, for patients with coma caused by hypercapnia, if the infection is not obvious or the general situation is good, non-invasive ventilators can still be the first choice for treatment.

In theory, patients with mild to moderate respiratory failure can choose non-invasive ventilators as their first choice, but if the patient has a lot of secretions, poor sputum excretion ability, or generally poor conditions, they should consider choosing an invasive ventilator that requires the establishment of an artificial airway; Patients with obvious restlessness should also choose tracheal intubation as their first choice. If the infection is significantly controlled in patients with respiratory failure who receive invasive mechanical therapy through tracheal intubation, but the patient still cannot tolerate spontaneous breathing, non-invasive mechanical therapy can be used for transition, especially for COPD patients.

According to existing reports, non-invasive ventilators are mainly used for patients with obstructive sleep apnea hypopnea syndrome (OSAHS), neuromuscular diseases, chronic respiratory failure in patients with chronic obstructive pulmonary disease, and acute and chronic heart failure. They are also used for patients with ARDS, postoperative patients with poor lung function, pneumonia, and patients with cystic fibrosis and respiratory failure. Many studies have shown success rates ranging from 60% to 90%, with a significant decrease in hospital infection rates, shorter hospital stays, and lower mortality rates.