Non-invasive ventilation in patients with an altered level of consciousness : a clinical review and practical insights

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respiratory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preservation of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed

Noninvasive ventilation : education and training. A narrative analysis and an international consensus document

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated. Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries

Continuous positive airway pressure in non-apneic asthma : a clinical review of the current evidence

The use of continuous positive airway pressure (CPAP) in the asthma has been a question of debate over the past several years. Various studies, including animal and human studies have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the current available literature on the physiologic and clinical effects of CPAP in animal models of asthma and humans with stable asthma

Noninvasive ventilation: education and training. A narrative analysis and an international consensus document

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the timeand if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of itsproper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training.Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviewswith the results analyzed by a team of experts across the world through e-mail based communications.Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies withindirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implementedonly in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIVeducation and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated.Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care usingNIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developingcountries