Multiprofessional Critical Care Review: Adult (2023)-6: Non Invasive Oxygenation and Ventilation Strategy (Robert C. Hyzy, MD, MCCM)

6: Non Invasive Oxygenation and Ventilation Strategy (Robert C. Hyzy, MD, MCCM)

Video Transcription

Video Summary

The lecture discusses noninvasive oxygenation and ventilation strategies in critically ill patients. The lecturer reviews the indications and use of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) in various conditions such as acute/chronic hypercapnic COPD, cardiogenic pulmonary edema, immunocompromised patients, post-extubation support, and more. HFNC has advantages such as avoiding endotracheal intubation, reducing ICU infections, and minimizing barotrauma. NIV can provide partial ventilatory support and has shown mortality benefits in COPD but should not be continued when it is clear that intubation is necessary. The lecture also highlights the use of heated high-flow nasal cannula (HHFNC) as an alternative to NIV, showing its effectiveness in preventing intubation and reducing mortality in hypoxemic respiratory failure patients. The use of a helmet with NIV has shown promise in ARDS patients. The lecture concludes by discussing the benefits of noninvasive ventilation in post-extubation support, with lower rates of re-intubation and mortality compared to conventional oxygen therapy. A combination of HFNC and NIV has also shown superior outcomes compared to HFNC alone in high-risk patients.

Keywords

noninvasive oxygenation

ventilation strategies

high-flow nasal cannula

noninvasive ventilation

acute/chronic hypercapnic COPD

cardiogenic pulmonary edema

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