Staff training influence on non-invasive ventilation outcome for acute hypercapnic respiratory failure

Abstract

NIV is a life-saving respiratory treatment influenced by several factors, of which staff training is a key one. Centres attending acute respiratory patients should have an area in which this requirement is fulfilled.

Noninvasive ventilation in acute respiratory failure: which recipe for success?

“…Despite the strong rationale and the huge volume of data in the literature dealing with physiological, clinical and technological features of NPPV, a "clear recipe" that a team should use in the clinical practice to deliver NPPV is lacking. Results of randomised controlled trials (RCTs) obtained by very selected centres with high experience in NPPV cannot be always translated into a "real-world" scenario where skills, standardisation and expertise may not be always adequate [16,17]. This is not surprising, since NPPV, like other treatments in medicine, has to be considered as a rational "art" and not just as an application of science; in other words, NPPV requires the ability of clinicians to choose case-by-case the best "ingredients" (i.e.…”

Randomized trial of ‘intelligent’ autotitrating ventilation versus standard pressure support non‐invasive ventilation: Impact on adherence and physiological outcomes

“…Initiating NIV requires specialist knowledge and expertise . Patient intolerance of the level of PS judged appropriate for therapeutic benefit is common, and NIV initiation is unsuccessful in up to 10% of patients .…”

“…[7][8][9][10][11][12][13] Initiating NIV requires specialist knowledge and expertise. 14,15 Patient intolerance of the level of PS judged appropriate for therapeutic benefit is common, and NIV initiation is unsuccessful in up to 10% of patients. [16][17][18] An intelligent 'learn' feature has been incorporated into the ventilator technology for the automated selection of ventilator settings based on the patient's wake breathing pattern.…”

Response

“…Dyspnea is a multidimensional sensation, usually evaluated with self-reported unidimensional intensity, using a dyspnea visual analog scale as reference. 2 Identifying and quantifying dyspnea is a challenging process, however, in particular in noncommunicative patients such as those who are critically ill and terminally ill presenting altered selfreport capabilities.…”