Non-invasive ventilation (NIV) is the provision of mechanical ventilation via a face mask. Using this face and mask, NIV technology provides positive pressure ventilation so that air and pressure are delivered to the lungs and smaller airways. Our experience has shown us that the use of NIV benefits those patients with chronic alveloar hypoventilation (see definitions). Benefits that patients see include improvements in sleep, nocturnal arterial oxygen saturation, diurnal and nocturnal arterial PCO2, and quality of life. Furthermore, proactive and timely outpatient care reduces the need for hospitalization (requiring emergency department and ICU resources).
NIV is used in many CAH syndromes secondary to central respiratory control disturbances, restrictive thoracic cage disorders, neuromuscular diseases (NMD), and the obesity-hypoventilation syndrome (OHS). There is less evidence for its benefit in the chronic outpatient management of severe COPD. Application of NIV via a mask interface avoids the morbidity involved with tracheostomy.
University Hospital operates regional programs for the care of patients with NMD and with Motor Neuron Disease (ALS). We have partnered with the NMD clinicians to assist in the ventilator care of their patients. This includes: earlier identification with respiratory referral and assessment; equipment acquisition; outpatient LTV initiation with patient and family training; and patient follow-up.
