Aspects pratiques et techniques de la ventilation non invasive

Abstract

Noninvasive ventilation refers to the delivery of positive pressure ventilation via a mask or "interface" rather than via an invasive conduit. Until recently, equipment for noninvasive ventilation was frequently custom-made to meet the needs of an individual patient. During the past 15 years, there have been significant advances in the equipment available for noninvasive ventilation. Interfaces that have been designed specifically for noninvasive ventilation are now commercially available from several manufacturers. Commonly used interfaces include nasal and full face masks, and mouthpieces. The main characteristics, and potential advantages and disadvantages of each interface are described. Portable volume-limited or pressure-limited ventilators are available for home noninvasive ventilation. As with critical care ventilators, home mechanical ventilators are capable of delivering a variety of modes of ventilation. Furthermore, they are lightweight and economical. Technical aspects of ventilator circuits are also discussed here and some practical considerations about selection and maintenance of materials are proposed. Although major technical advances have been made, optimal delivery of noninvasive ventilation requires knowledge of, and experience with, the application of the equipment used.