Respiratory Care in Non Invasive Mechanical Ventilatory Support: Principles and Practices

Description

Non-invasive ventilation refers to the use of breathing support administered through a face mask, nasal mask, or helmet. This form of ventilatory support is useful in the treatment of respiratory illnesses including SARS, MERS, PH1N1, and COVID-19. Consisting of 63 chapters, this book provides a detailed, holistic overview of the principles and practice of non-invasive mechanical ventilatory support. Contents Preface Chapter 1 Respiratory Muscular Function and Anatomy. Implications for Respiratory Care Abstract Introduction Respiratory Muscles Process of Inspiration Process of Active Inspiration Process of Passive Expiration Process of Active Expiration Anatomy of Respiratory Muscles Diaphragm External Intercostal Muscles Scalene muscle Anterior Scalene Muscle Middle Scalene Muscle Posterior Scalene Muscle Sternocleidomastoid Pectoralis Major Muscle Pectoralis Minor Muscle Serratus Anterior Latissimus Dorsi Rectus Abdominis Muscle Internal Intercostal Muscles Innervation of Respiratory Muscles Respiratory Muscles in Stress References Chapter 2 Gas Exchange During Non-Invasive Ventilation Abstract Introduction The Good The Bad The Ugly Alterations of the Arterial Alveolus Gradient Shunt Ventilation / Perfusion Disturbance Limitation of Diffusion Dead Space Alveolar Hypoventilation Benefits of Non-Invasive Mechanical Ventilation in the Exchange of Gases References Chapter 3 Spontaneous Ventilation Determinants: Lung Compliance and Airway Resistance Abstract Lungs’ Elastic Recoil Recoil of the Lung Forces Action of Surfactant Time Dependence of Pulmonary Elastic Behavior Thoracic Cage Elastic Recoil Lung Plus Thoracic Cage Pressure/Volume Relationships Respiratory System Resistance Gas Flow and Resistance Physical Principles Laminar Flow Turbulent Flow Airway Resistance Inertance and Respiratory System Resistance References Chapter 4 Pulmonary Function Monitoring. Implications for Respiratory Care in Non-Invasive Mechanical Ventilation Abstract Introduction Physiological and Ventilatory Indicators During VMNI Pulse Oximetry (SpO2) Arterial Gasometry (ABG) Transcutaneous CO2 Measurement (tcpCO2) End-Tidal CO2 (ETCO2) Respiratory Rate (RR) Expiratory Tidal Volume (VTE) I/E Ratio Leaks Positive Intrinsic Epiratory Pressure (PEEPi) Waveforms Patient-Ventilator Interaction Alarms Monitoring Categories / Monitoring Scales Technological Advances in Monitoring Systems Key Messages References Chapter 5 Waveform Analysis during Noninvasive Ventilation Abstract Abbreviations Introduction General Concepts Scalar Graphics Flow-Time (F-T) Rise Time Airway Obstruction Air Trapping Volume-Time (V-T) Air Leak Changes in Pulmonary Mechanics Pressure-Time (P-T) Patient-Initiated Breath Loops Pressure-Volume Loop (PVL) Changes in Pulmonary Mechanics Air Leak Flow-Volume Loop (FVL) /H3/Air Leak /H1/Ventilator Mode Recognition BIPAP Conclusion Key Messages References Chapter 6 Noninvasive Ventilatory Support. Technology, Devices, Classification and General Indications Abstract Introduction Goals of Noninvasive Ventilation Noninvasive Ventilation Technology Driving Power/Energy Control System and Sensors Control and Phase Variables Circuit Patient Interface Filters Humidification Display and Control Panel Oxygen Inlet and Blender Systems Electric Supply and Battery Backup Devices and Classification of Noninvasive Ventilation General Indications and Contraindications for Noninvasive Ventilation Contraindications for Noninvasive Ventilation Complications of Noninvasive Ventilation Success of Noninvasive Ventilation References Chapter 7 Equıpment for Nonınvasıve Ventılatıon Physıcs and Prıncıples Abstract Abbrevıatıons 1. Introductıon 2. Methodology 2.1. Heating and Humidifying the Air Used During Noninvasive Mechanical Ventilation 2.2. Complications Related to Equipment 3. About Our Research 3.1. Learning Points 3.2. Critical Points Conclusıon References Chapter 8 Nasal High Flow Oxygen. Technology and Devices Abstract Abbreviations Nasal Interface Flow Generator Humidifying Devices Inspiratory Limb Conclusion Key Messages References Chapter 9 Nasal High Flow Oxygen. Clinical Indications and Basic Respiratory Care Abstract Introduction High Flow Nasal Cannula Mechanics Overview Physiological Dead Space Washout and Increased Tidal Volume Decreased Respiratory Rate Positive End-Expiratory Pressure Increased End-Expiratory Volume Clinical Significance Initial Settings and Adjustments Where to Start Flow Rate FiO2 Humidification Making Adjustments Contraindications Conclusion References Chapter 10 CPAP High Flow Oxygen Devices Abstract Introduction Benefits Constant Delivered FiO2 Positive End-Expiratory Pressure Generation Fraction of Inspired Oxygen Aerosol Therapy Disadvantages of Using HFNC References Chapter 11 Mask Interface in Non Invasive Mechanical Ventilation( Abstract Introduction Non-Invasive Interfaces Oral Mask Indications Advantages Disadvantages Absolute Contraindications Oral Mouthpiece Indications Advantages Disadvantages Absolute Contraindications Nasal Mask Indications Advantages Disadvantages Absolute Contraindications Nasal Pillows Indications Advantages Disadvantages Absolute Contraindications Oronasal Mask (Full Face Mask) Indications Advantages Disadvantages Absolute Contraindications Total Face Mask Indications Advantages Disadvantages Absolute Contraindications Helmet Indications Advantages Disadvantages Absolute Contraindications Troubleshooting Air Leaks Negative Effects Solutions Dead Space Negative Effects Solutions Challenges with Pediatric Interfaces Negative Effects Solutions Skin Breakdown Negative Effects Solutions Conclusion References Chapter 12 Noninvasive Positive Pressure Ventilation Modes Abstract CPAP - Continuos Positive Airway Pressure Bi-Level Modes Pressure Pressure Support Ventilation (PSV) Spontaneous Mode (S) Spontaneous/Timed Mode (S/T) Pressure Controlled Ventilation (PCV) Timed Mode (T) Proportional-Assist Ventilation (PAV) Volume-Targeted Modes Volume-Assured Pressure Support (VAPS) Volume-Controlled Ventilation (VCV) Conclusion References Chapter 13 Continuous Positive Airway Pressure (CPAP) Abstract Introduction Concept and Physiopathology Indications CPAP Systems Conclusion References Chapter 14 Bi-Level Positive Airway Pressure-BiPAP Abstract Introduction Main Points Conclusion References Chapter 15 Hybrid Ventilatory Modes AVAPS and NAVA Abstract Introduction AVAPS Setting of AVAPS Indications of AVAPS Advantages of AVAPS NIV-NAVA Setting of NAVA Indications of NAVA Advantages of NAVA Key Messages References Chapter 16 Continuous Non-Invasive Ventilatory Support Abstract Introduction Non-Invasive Ventilatory Support and Respiratory Mechanics Chest Compliance Resistances in Upper Airways Use of Continuous Non-Invasive Ventilation and Choice of Mask Interface Oronasal Masks Nasal Masks Mouthpiece Factors that Assist in Adherence to Continuous Noninvasive Ventilatory Support in Neuromuscular Diseases - the Choice of Ventilators Types of NIV Ventilators Auxiliary Equipment - Mechanical Insufflation-Exsufflation Device Pulmonary Insufflation Exercises Impact of Noninvasive Ventilation on Oral Communication in Neuromuscular Diseases Correlation between Lung Capacity and Speech Function Noninvasive Ventilation and Swallowing in Neuromuscular Diseases The Impact of Mask Interface on Speech and Swallowing Functions Conclusion Key Messages References Chapter 17 Methodology of Non Invasive Ventilation. Ventilator Settings and Withdrawal Protocols Abstract Introduction High-Flow Nasal Cannula Oxygen Settings Non-Invasive Mechanical Ventilation Settings Prescription of Therapy Weaning for Non-Invasive Mechanical Ventilation Introduction Weaning of Ventilation Acknowledgments References Chapter 18 Asynchrony Non Invasive Ventilation. Implications for Respiratory Therapist Abstract Abbreviations Introduction Importance of Patient-Ventilator Interaction NIV Asynchrony NIV Failure Leak Compensation Improvement of NIV Synchronization NIV Monitoring Conclusion References Chapter 19 Non Invasive Mechanical Ventilation Complementary Technology for Non Invasive Ventilation Therapy. Humidification Devices Abstract Abbreviations Introduction Discussion and Analysis Main Topic Normal Humidification Humidification in NIV Indications of Use Contraindications of and Adverse Effects Types of Humidifiers Conclusion Key Messages References Chapter 20 Management of Airway Secretions – Airway Clearance Therapy Abstract Introduction Airway Clearance Therapy (ACT) Postural Drainage and Breathing Exercises Conclusion References Chapter 21 Respiratory Care and Non Invasive Ventilation. Aırway Secretıons Devıces Abstract Introduction High Frequency Chest Wall Oscillation Contraindications Relative Contraindications Intrapulmonary Percussive Ventilation References Chapter 22 Airway Secretions Devices: Mechanical Insufflator-Exsufflator- Cough Assisted Abstract Cough Peak Cough Flow Lung Volume Recruitment Techniques - Assisted Cough Mechanical Insufflation-Exsufflation Mechanical Insufflation-Exsufflation in Neuromuscular Diseases Therapy Modes and Standard Treatment Procedures - Coughtassist( T70/E70 (Philips Respironics) General Therapy Description [9-14] Manual Automatic Cough-Trak Oscillation Adapting to the Patient – How to Start? [9-14] References Chapter 23 Aerosol Therapy Evidence in NIV-Nasal High Flow Aerosols- and Pharmacology Abstract 1. Introduction 2. Physiological Rationale and Mechanism of Actions 2.1. Technical Features and Oxygenation Effect 2.2. Airways Ventilation Support 2.3. Humidification and Comfort 2.4. Mucociliary Clearance 3. Factors Affecting Aerosol Delivery During Non-Invasive Ventilation and High Flow Therapy 3.1. Airway Anatomy and Lung Disease Injury 3.2. Aerosol Generator Type in the Circuit 3.2.1. Nebulizers 3.2.2. pMDIs 3.3. Mode of Nebulizers 3.4. Aerosol Generator Type and Its Location within the Circuit 3.5. Nebulizer Dead Volume 3.6. Humidification and Heat of the Circuit 3.7. Gas Flow Rate 3.8. Gas Density 3.9. Interfaces 3.10. Aerosol Aerodynamic Effect 3.11. Patient Position 3.12. Ventilator-Associated Factors Affecting Aerosol Delivery 4. Current Clinical and Pharmacological Aerosol Therapy Applications During Ventilation Using NIV and HFT 4.1. Acute Hypoxemic Respiratory Distress 4.2. Acute COPD Exacerbations 4.3. Immunocompromised Patients with ARF 4.4. Cardiogenic Pulmonary Edema 4.5. Post-Extubation 4.6. Palliative Care 5. Patient Selection 6. Complications 7. Discontinuation 8. Prediction of NIV and HFT Failure References Chapter 24 Complications Noninvasive Ventilation. How Respiratory Therapists Act Abstract Introduction Complications of Noninvasive Ventilation Minor Complications [7, 8, 9, 10] Subjective Mask Discomfort Claustrophobia Intolerance of the Technique Skin Lesions Acneiform Skin Rash Necrosis of the Skin Oral and Nasal Dryness Nasal Congestion and Obstruction Conjunctival Irritation Major Complications [7, 8, 9, 10] Air Leaks Patient-Ventilator Dyssynchrony (PVD) Hypercapnia Gastric Insufflation Barotrauma Hemodynamic Alterations Aspiration Key Messages References Chapter 25 Aerosol Therapy during Non-Invasive Ventilation Abstract Introduction Factors Affecting Aerosol Delivery druring NIV Types of Aerosol Devices and Delivery Technique Position of Aerosol Devices Ventilator Modes and Parameters Position of the Leak Port Type of Exhalation Valve Humidification Type of Interface Enhanced Condensational Growth Conclusion Key Messages References Chapter 26 Respiratory Care. Non Invasive Mechanical Ventilation and Use of Thoracic Ultrasound Abstract Introduction Ultrasound Technique and Examination Clinical Use of Ultrasound Conclusion References Chapter 27 Non Invasive Mechanical Ventilation in Acute Cardiac Pulmonary Edema Abstract 1. Introduction 2. Pathophysiology of Acute Heart Failure and Acute Cardiogenic Pulmonary Edema [6] 3. Benefit of Positive Airway Pressure in CPE: Pathophysiology 4. NPPV in ACPE: Current Evidence 4.1. NPPV in ACPE and Risk of Acute Myocardial Infarction (AMI) 5. Current Recommendations on NPPV for ACPE from International Societies 6. Risk Factors of Non-Invasive Ventilation Failure in Patients with ACPE 6.1. Consider ETI in ACPE, in Case of [5] 7. How to Program NPPV in ACPE [6] 7.1. Device Settings 7.2. Monitoring Key Messages References Chapter 28 Non Invasive Ventilation in the Treatment of Pneumonia and Adult Respiratory Distress Syndrome Abstract Introduction Patient Selection Initiating NIV Predictive Factors for NIV Failure Discussion References Chapter 29 Non Invasive Mechanical Ventilation in Multiple Trauma - Blunt Chest Injury Abstract 1. Introduction 2. Pathophysiology and Clinical Features 2.1. Rib Fractures and Flail Chest 2.1.1. Flail Chest 2.2. Lung Contusion 2.3. Pneumothorax 2.4. NIV and Blunt Thoracic Trauma (BTT) 2.4.1. Benefits of NIV in BTT Patients 2.4.2. Contraindications to NIV in BTT Patients 2.4.3. Indication for NIV in BTT Patients 2.4.4. Failure of NIV in BTT Patients 2.4.5. Comparison of Deferent Modes of NIV in BTT Patients 2.4.6. Side Effects of NIV in BTT Patients Conclusion Key Messages References Chapter 30 Non-Invasive Mechanical Ventilation in Immunocompromised Patients. Key Respiratory Care Issues Abstract Introduction Current Evidence Non-Invasive Ventilation High Flow Nasal Therapy Non-Invasive Ventilation versus Invase Ventilation Conclusion References Chapter 31 Non Invasive Mechanical Ventilation in High-Risk Infections – Respiratory Care- SARS, MERS, pH1N1, Coronavirus Abstract Introduction Management of Adults Hypoxemic Respiratory Failure Conditions in High Risk Infection– Options Available NIPPV vs HFNO – A Balance between Advantages and Disadvantages Some Particularities in Management of High-Risk Infections Key Messages References Chapter 32 Respiratory Care in Non Invasive Ventilation Approach in Obstetrics Abstract Introduction Respiratory Physiological Changes to Consider in Pregnancy Upper Airway Chest Wall Respiratory Muscle Static Lung Function Spirometry Airway Resistance and Conductance Closing Volume Diffusing Capacity Minute Ventilation Dead Space Hyperventilation and Dyspnea Oxygen Consumption and Production Oxygen Tension Arterial Blood Values Principal Changes in Labor, Delivery and Postpartum Causes of Respiratory Failure in Pregnancy Non Invasive Ventilatory Management in the Pregnant Patient Other Reasons to Take Into Account at the Moment to Use NIV in Pregnancy Contraindications of NIV and Predictor of NIV Failure in Pregnancy References Chapter 33 Cardiothoracic and Neurologic Surgery Abstract 1. Introduction 2. Physiologic Effects of NIV on Cardiopulmonary and Neurologic System 2.1. Heart and Circulation Effects 2.2. Central Nervous System (CNS) 3. Specific Sights of Surgery Impact on Patient 3.1. Cardiothoracic 3.2. CNS 3.3. Risk Factors for Postoperative Pulmonary Complications - ARF 4. Types of NIV 5. Benefits of NIV 6. Indications of NIV in Perioperative Period 7. Contraindications to NIV 8. NIV Failure 9. Complications of NIV 10. Patient Care 11. Perioperative NIV 11.1. Pre-Operative NIV 11.2. Intraoperative NIV 11.2.1. Cardiac Surgery 11.2.2. Thoracic Surgery 11.2.3. Neurosurgery 11.3. Postoperative NIV 11.3.1. Thoracic Surgery 11.3.2. Cardiac Surgery 11.3.3. Cranial Surgery Conclusion Key Messages References Chapter 34 Weaning/Extubation Respiratory Failure Abstract Introduction Techniques of Respiratory Support after Extubation Oxygen Non-Invasive Ventilation High-Flow nasal Therapy Postextubation Ventilatory Support in Critically Ill Medical Patients Preventive Strategy Non-Invasive Ventilation vs Conventional Oxygen Therapy High-Flow Nasal Therapy vs Conventional Oxygen Therapy Non-Invasive Ventilation vs High-Flow Nasal Therapy Facilitative Strategy Therapeutic Strategy Conclusion References Chapter 35 Tracheostomy Decannulation and Non Invasive Ventilation: Role of Respiratory Therapist Abstract Introduction Clinical Stability Airway Patency Swallowing Assessment Conscience Level Coughing Effort Management of Secretions References Chapter 36 Non Invasive Ventilation in Chronic Obstructive Pulmonary Disease Abstract Abbreviations 1. Introduction 2. Physiological Alterations in COPD Relevant to Ventilator Support 3. Indications of NIV in COPD 3.1. NIV in Acute Exacerbation 3.2. Long Term NIV in COPD 3.3. Home NIV for COPD 3.4. NIV to Facilitate Weaning in COPD 3.5. Non-Invasive Ventilation as an Addition to Pulmonary Rehabilitation in Severe Stable COPD 4. When to Stop NIV in COPD Patients Conclusion References Chapter 37 Respıratory Care in Non Invasıve Mechanıcal Ventılatory Support: Cystıc Fıbrosıs (CF) Populatıon Abstract Introduction Acute Exacerbation Airway Clearance and Improvement in Quality of Life Chronic Maintenance Therapy/Bridge to Transplantation Conclusion References Chapter 38 Non Invasive Mechanical Ventilation in Asthma Exacerbation Abstract Introduction Risk Factors Associated to Asthma Exacerbation Pathophisiology of Asthma Exacerbations Benefits of NIV Selecting the Patient Programming NIV Discontinuation Conclusion References Chapter 39 Neuromuscular Disorders Abstract Definition and Classification of Neuromuscular Disorders Pathophysiology of NMD Epidemiology of NMD Impact of Neuromuscular Diseases on the Respiratory System Respiratory Muscle Strength Cough Function Abnormalities Sleep Abnormalities Reduction in Respiratory System Compliance Methods of Assessment Spirometry Mouth Pressures and Sniff-Nasal Inspiratory Pressure Peak Cough Flow Sleep Studies Blood Gases Imaging Monitoring Treatment Options Non-Invasive Ventilation Assisted Coughing Long Term Oxygen Therapy e Bronchodilators Sialorrhea Management Neurogenic Dysphagia Management References Chapter 40 Noninvasive Mechanical Ventilation in Chest Wall Respiratory Disorders. Respiratory Care Abstract Introduction Pathophysiology of Chest Wall Abnormalities and Respiratory Failure Mechanism and Benefits of NIV in Chest Wall Disorders Patient Selection High Risk Patients for Respiratory Failure Therapy in Patients with Installed Respiratory Failure Contraindications Initiation and Monitoring of NIV Key Messages References Chapter 41 Non Invasive Ventilation for Patients with Obesity Hypoventilation and Acute Hypercapnic Respiratory Failure Abstract Introduction Review Method Management of Acute-on-Chronic Exacerbation in Patients with OHS Oxygen Therapy Positive Airway Pressure Therapy Noninvasive Ventilation in Acute-On-Chronic Exacerbation of OHS Other Ventilatory Modes Dedicated NIV versus ICU Ventilators Predictors of Failure of NIV Conclusion Acknowledgments References Chapter 42 Non Invasive Mechanical Ventilation in Sleep Breath-ing Disorders Abstract Introduction Choosing, Initiation and Titration of Non Invasive Ventilation (NIV) in Sleep Disorders Sleep Apnoea (Obstructive or Central) Obstructive Sleep Apnoea (OSA) Central Sleep Apnoea (CSAS) Sleep-Related Hypoventilation (Obesity or Neuromuscular Disorders) Obesity-Hypoventilation Syndrome Neuromuscular Diseases Sleep-Breathing Disorders Associated with Chronic Respiratory Disorders Conclusion Key Messages References Chapter 43 Non Invasive Mechanical Ventilation: Neuropsychiatric Disorders and Respiratory Care in Elderly People Abstract Introduction Delirium Dementia The Management of Behavioral Disorders Drug Therapy Delirium Treatment Drug Therapy of Behavioral Disorders in the Person with Dementia (BPSD) Treatment of Affective Symptoms Treatment of Neuro-Vegetative Symptoms Disorders of Sexual Behavior Eating Disorders Treatment of Specific Behaviors Recommendations of the Italian Medicines Agency (AIFA) on the Pharmacological Management of BPSD Physical Restraint References Chapter 44 Non Invasive Mechanical Ventilation and Respiratory Physiotherapy and Pulmonary Rehabilitation Abstract Respiratory Physiotherapy Manual Techniques and Exercises Mechanical Techniques and Devices Mobilization Weaning and Decannullation Pulmonary Rehabilitation References Chapter 45 Non Invasive Ventilation in Bronchoscopy and Sedation. Implications for Respiratory Therapist Abstract History of Bronchoscopy Sedation for the Bronchoscopy Patient Moderate Sedation Deep Sedation Indications for Bronchoscopy Contraindications for Bronchoscopy Bronchoscopes Standard Practice for Bronchoscopy Procedures Complications of Bronchoscopy Workflow Chart References Chapter 46 Non Invasive Ventilation in Non-Bronchoscopy Sedation (Cardiology - Gastroenterology, Catheter Insertion). Implications for Respiratory Therapist Abstract 1. Introduction 2. Types of NIV 3. NIV Mask Selection 4. Benefits of NIV 5. Indications for NIV in Sedation Procedures 6. Contraindications to NIV in Sedation Procedures 7. Side Effects of NIV 8. Failure Criteria for NIV 9. Patient Care 10. Recent Findings 10.1. NIV in Gastroenterology 10.2. NIV in Cardiology Conclusion Key Messages References Chapter 47 Nasal High Flow Use in COPD Abstract Introduction Indications References Chapter 48 Hospital Discharge Program to Home Care Non-Invasive Ventilation Abstract 1. Introduction 2. Objectives 3. Methodology 3.1. Clinical Situations 3.2. Criteria 3.3. Voluntary Participation 4. Process 4.1. Process of Equipping the Patient’s Home 4.2. NIV Process of Installation at Home 4.3. Monitoring Process 4.4. Personnel Evaluation Process 5. Adverse Effects 6. Contraindications to Home Mechanical Non-Invasive Ventilation (Hnmv) 7. Benefits of Home Mechanical Home Ventilation Conclusion Key Messages References Chapter 49 Home Non Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disorders. Role of Respiratory Therapist Abstract Introduction Physiopathological Basis Indications of Non-Invasive Home Mechanical Ventilation in Stable EPOC Other Factors Related to the Effectiveness of Home Noninvasive Mechanical Ventilation Key Messages References Chapter 50 Home Non Invasive Mechanical Ventilation in Neuromuscular Disorders: Implications for Respiratory Therapist Abstract 1. Introduction 2. Pathophysiology of NIV in Patients with Neuromuscular Diseases 3. Indications and Contraindications 4. Equipment and Modalities of Home Noninvasive Ventilation 4.1. CPAP (Continuous Positive Airway Pressure) 4.2. BiPAP (Bilevel Positive Airway Pressure) 5. Home NIV and the Pediatric Patient 6. Home NIV in Adult Patients 7. When to Institute Home NIV 8. Care in Home Care Conclusion References Chapter 51 The Use of Non-Invasive Ventilation in Prolonged Mechanical Ventilation and Respiratory Care Abstract Introduction to Prolonged Mechanical Ventilation Using NIV on Specialty Weaning Units Conclusion References Chapter 52 Respiratory Care and Non Invasive Ventilation in Neonatology Abstract Abbreviations Introduction Nasal Continuous Positive Airway Pressure (NCPAP) Physiological Effects Indications Application Methods and Systems Methods for Providing NCPAP Failure of CPAP Nasal Intermittent Positive Pressure Ventilation (NIPPV) Physiological Effects Devices Optimal Parameters NCPAP/NIPPV Removal Non-Invasive High-Frequency Oscillatory Ventilation (NHFOV) Complications of NIV Nasal Injury: Nasal Mucosa/Nasal Septum References Chapter 53 Assessment of Pain/Distress During Non Invasive Ventilation in Pediatric and Respiratory Care Abstract MeSH Terms Nasal Injuries: Effect of NIV Interface Causes of Pain in ICU Barriers to Effective Pain Management in the ICU Phase of Life with Psychological Responses to Pain and Distress How to Assess Pain in Conscious Children Receiving NIV? How to Assess Pain in Sedated Children Receiving NIV? Long Term Negative Effects of Acute Postoperative Pain Pain in ICU Should Be Treated Properly References Chapter 54 Aspects of Psychological Support for Children During Respiratory Care (Non-Invasive Ventilation) Abstract Introduction Claustrophobia Agitation and Delirium Anxiety Dyspnea During NIMV Dependence and Autonomy Post-Traumatic Stress Syndromes Management References Chapter 55 Counseling of Parents, Ethical Aspects, Consent, or Ascent for Children for Preparing the Family Members for Shifting Care from Ward to Home: Educational and Training Aspects for Respiratory Therapist Abstract Introduction Respiratory Care: From Hospital to Home Home NIV: Obstacles and Ways to Overcome Them Training of the Affected Child Importance of Understanding the Psychology of the Child Training of the Caregiver Ethical Aspect: ‘Consent’ or ‘Assent’ and Implication of Age Counselling of Parents End-of-Life Care, Palliative Care, and ‘Comfort Measures Only’ References Chapter 56 Respiratory Care in Intrahospital and Prehospital Patients with Non Invasive Ventilator Support Abstract Abbreviations Introduction Intra-Hospital Transport and NIV Selection of Candidates for Intra-Hospital NIV Transport Provision Resources Equipment Required during NIV Transport Control and Monitoring Pre-Hospital Transport and NIV NIV Indications and Selection of Patients to Be Transported on NIV Provision Resources Control and Monitoring Conclusion Key Messages References Chapter 57 Non Invasive Ventilation in Critical Care. General Aspects for Respiratory Therapists Abstract Introduction Before Starting NIV Patient Selection COPD Exacerbations Acute Cardiogenic Pulmonary Edema (ACPE) Asthma Postextubation Other Diseases Interface Selection Humidification Practical Guidelines COPD Exacerbation Acute Cardiogenic Pulmonary Edema Asthma Conclusion References Chapter 58 Non-Invasive Ventilation-Respiratory Care. Organization in Critical Care Unit Abstract Introduction Equipment Caregiver’s Training Organization Advantages And Disadvantages Management of NIMV in ICU References Chapter 59 Respiratory Care in Anesthesiology Pre-Intubation and Upper Airways Procedure Abstract Introduction Physiologic Basis of Preoxygenation and Apneic Oxygenation High-Risk Patients of Hypoxemia Elderly Patients Morbid Obesity Pulmonary Disease Critically Ill Patients Modalities of Preoxygenation and Apneic Oxygenation in Patient at High Risk of Hypoxemia High-Flow Nasal Oxygen (HFNO) Noninvasive Ventilation (NIV) Preoxygenation in the Patient at High Risk of Hypoxemia. Recommendations Noninvasive Ventilation in Procedures Involving the Airway References Chapter 60 Respiratory Care and Non Invasive Ventilation. Anesthesiology and Postoperative Medicine Abstract Introduction Who Will Need NIMV? [5] Contraindications for NIMV in the Postoperative Period [5] What Goals of Therapy Can Be Achieved with NIMV in the Postoperative Patient with ARF? [6] Patients Who May Benefit from Postoperative Use of NIMV [7] NIMV in the Postoperative Period of Abdominal Surgery NIMV in the Postoperative Period of Bariatric Surgery NIMV in the Postoperative Period of Thoracic Surgery NIMV in the Postoperative Period of Lung Transplant NIMV in the Postoperative Period of Liver Trasplant Evidence on Postoperative Use of NIMV [11] Key Messages References Chapter 61 Respiratory Care in Non Invasive Ventilation in Ward Abstract Introduction Conclusion References Chapter 62 Respiratory Care in Noninvasive Ventilation-Post-Intensive Care Step Down Unit Abstract Introduction History of Noninvasive Ventilation and Step Down Units Step Down Unit Clinical Outcomes Step Down Units and Clinical Deterioration References Chapter 63 Respiratory Therapist Education, Policies, and Protocols. Key Recommendations Abstract Introduction ADDIE Policies and Procedures References About the Editors Index Blank Page