Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about non-invasive ventilation.

And if you want to follow along with written notes on this topic, you can follow along at

0tofinals.com slash niv or in the respiratory section of the Zero to Finals Medicine book.

So let's get straight into it.

Non-invasive ventilation is an important alternative to full intubation and ventilation.

And it's used to support the lungs where there's respiratory failure due to obstructive lung disease.

Intubation and ventilation involves giving the patient a general anaesthetic, putting a plastic tube into their trachea and then ventilating the lungs artificially.

And non-invasive ventilation involves using a full face mask or a tight-fitting nasal mask

that forcefully blows air into the lungs and ventilates them without having to intubate them.

It's not a pleasant experience, however it's much less invasive than full intubation and

ventilation and it acts as a middle point between basic oxygen support and intubation and ventilation, and it acts as a middle point between basic oxygen support and

intubation. Non-invasive ventilation comes in two types. The first is bi-pap, and the second is CPAP.

Bi-PAP stands for bi-level positive airway pressure, and this involves a cycle of high and low pressure to

correspond to the patient's inspiration and expiration. Bipap is used where there's type 2 respiratory

failure, typically in COPD patients. The criteria for initiating BIPAP are that they must have a respiratory acidosis,

so their pH needs to be less than 7.35, and their P.A.O.2 needs to be greater than 6,

so they need to be retaining carbon dioxide that's causing an acidosis.

And this needs to be the case despite adequate medical treatment.

So if they're just admitted and they have these values,

they need some medical treatment first with nebulizers and so on

before you can justify putting them on non-invasive ventilation.

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