GE Healthcare: Introduction to Non-Invasive Ventilatory Support in the ICU

Speaker: Lisa Nolan

Key Topics Covered:

1. Purpose of Non-Invasive Ventilatory Support

   • Used for patients with acute respiratory failure, COPD, or cardiogenic pulmonary edema.
   • Provides an alternative to intubation based on disease severity.

2. Non-Invasive Ventilation (NIV) Mode on Carescape R860

   • Provides positive pressure ventilation for spontaneously breathing patients.
   • Delivered via nasal or full-face mask.
   • Masks should be non-vented and exclude an entrainment valve.

3. Patient Criteria for NIV Mode

   • Must be responsive.
   • Capable of spontaneous breathing.
   • Requires pressure support ventilation.

4. Ventilator Settings for NIV Mode

   • Includes setting PEEP and pressure support levels.
   • Other adjustable parameters:
     • Pressure support time
     • Inspiratory and expiratory triggers
     • Bias flow
     • Rise time
   • Simultaneous application of flow and pressure triggers to address circuit leaks.

5. Safety and Backup Measures

   • Set maximum pressure backup inspiratory pressure, minimum rate, and backup inspiratory time.
   • In case of no spontaneous breaths detected, a high priority alarm activates.
   • Ventilator alternates between pressure control and support based on patient's effort and minimum rate.

6. Alarm Management

   • Disabling certain alarms (e.g., low expired minute ventilation, apnea time, and leak alarm limits) might be necessary to avoid nuisance alarms.
   • Medium priority alarm indicates when alarms are disabled.
   • Audio pause option to acknowledge alarms.
   • Additional monitoring recommended if alarms are disabled (e.g., pulse oximetry, ECG, end-tidal CO2).

Conclusion

• Using NIV mode on Carescape R860 is straightforward for spontaneously breathing patients.
• Ensures patient safety with proper setup and monitoring.