Goal is to treat Cheyne-Stokes respiration/central sleep apnea.
In the past 2 decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions (coughing, swallowing, feeding, speech), decrease airway injury, and prevent respiratory tract infections.In the outpatient setting, it provides ventilatory support, again preserving normal physiologic functions while allowing ambulation, travel and care at home.Several modes of mechanical ventilation can be delivered with home and critical care ventilators; we focused on those reviewed in the manuscript.The device also increase functional residual capacity but does not directly augment the tidal volume.Thus, numerous modes of noninvasive ventilation are available, each with a proprietary brand name.
The literature is plagued with different names and acronyms to refer to the same mode of ventilation (Table 1).
In these devices, a target tidal volume or alveolar ventilation is set, and the device adjusts the pressure support to reach that target.
The advantage of this mode of ventilatory support is to guarantee a delivered tidal volume despite variability in patient effort, airways resistance and lung or chest wall compliance.
Thus, the basic concept of NIPPV is the application of positive pressure during the respiratory cycle (inspiration and expiration).
The simplest application is that of continuous positive pressure through the respiratory cycle, which is named CPAP.
As such, it is more effective in hypoxemic compared with hypercapnic states.