NONINVASIVE MECHANICAL VENTILATION IN THE CRITICAL CARE UNIT

Non-invasive mechanical ventilation is useful in order to delay or avo id endotracheal intubation. Continuous positive airway pressure (CPAP) is helpful for patients with decreased lung compliance, airways obstr uction due to vocal cord paralysis or tracheobronchomalacia, presence of auto-PEEP (positive end-expiratory pressure) and as a weaning metho d. Non-invasive intermittent positive pressure ventilation (IPPV) is n ot very different from conventional mechanical ventilation except for the absence of an endotracheal tube. It is specially useful in patient s with neuromuscular diseases or central hypoventilation. It has been also helpful for patients with decrease of lung compliance or COPD and as a weaning procedure. It may be applied with or without PEEP and by means of a bi-level IPPV system. All of these methods require coopera tive patients and by means of a bi-level IPPV system. All of these met hods require cooperative patients and they do not allow an adecuate ma nagement of increased respiratory secretions. Non-invasive mechanical ventilation has the advantages of not showing complications associated to endotraqueal intubation and may be performed by means of less expe nsive equipment.