All right, so welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas and we're going to talk about non-invasive respiratory support.

So today we got the full tour de jour.

Don't we, Josh.

So we got primary modalities we'll cover BIPAP and High flow and we'll really go into the groundwork

of when we use non-invasive support.

What are your goals?

What are your assessments?

What are the traps?

We'll go into the nuances around how to sedate and stabilize someone on non-invasive.

And of course, always who is appropriate and who is not.

So let's get right into it, Josh.

Start me off with

when is this a good idea and when may it not be a good idea?

And just jumping in here before we really get started here, I just want to emphasize right

up front that there is not really strong evidence for just about anything in this chapter.

And you know, this is always a theme in critical care. I think

most of our chapters aren't really incredibly solidly supported. But I think this is especially true

in respiratory support. And when you really dig into the literature, it's basically almost

impossible to do a study to say, you know, we're going to randomize people. 50% of them, we're going

to intubate. 50% we're going to put on bipap. We're never going to intubate the Bipat patients and just like see who dies. Or to truly test the necessity of intubation, I feel like, is very almost impossible.

And a lot of the studies out there are kind of circular in some way. So we're going to do our best.

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