Non invasive ventilation

Non-invasive Ventilation Modes (NIV)

Solutions 

Avoid Intubation with CPAP

Non-invasive Ventilation Modes (NIV)

If the patient is breathing spontaneously, you can avoid emergency intubation and the risks associated with it by using non-invasive ventilation. Non-invasive ventilation has proved successful in certain symptoms; this refers to mask ventilation without intubation or tracheotomy. The patient’s breathing is supported, they can continue to breathe spontaneously, and often do not need to be sedated at all or only very lightly – they remain responsive.

A typical indication for NIV therapy in an out-of-hospital environment is acute shortness of breath e.g. exacerbated COPD, asthma, or pulmonary edema.

MEDUMAT Transport and MEDUMAT Standard² have an integrated CPAP mode and additional ventilation modes which can be used for non-invasive ventilation. In CPAP therapy, positive airway pressure is continuously maintained. The combination with ASB (assisted spontaneous breathing) allows for pressure support during inhalation to be switched on.

The CPAP mode is integrated into the MEDUMAT Transport and MEDUMAT Standard².

In MEDUMAT Transport, the additional NIV function can be activated in all pressure-controlled modes. This deactivates the leakage alarm and MEDUMAT Transport uses accordingly optimized trigger algorithms. This function is not necessary for MEDUMAT Standard².

Oxygen therapy, during which the patient inhales oxygen without breathing support by means of a mask or nasal cannula, is possible with all WEINMANN medical ventilators. In the demand or pre-oxygenation function, oxygen is saved during inhalation, as the oxygen is exclusively administered during inhalation.

On MEDUMAT Transport, MEDUMAT Standard² and MEDUVENT Standard, the following ventilation modes can be administered via the mask as non-invasive ventilation methods:

  • CPAP (continuous positive airway pressure)

  • CPAP + ASB (continuous positive airway pressure + assisted spontaneous breathing)

  • BiLevel + ASB, aPCV and PCV

  • CPAP + PS (MEDUVENT Standard)

More about pressure control ventilation
 

The following functions are available for pre-oxygenation or oxygen therapy:

More about special ventilation modes

Not-invasive ventilation CPAP curve

CPAP

Continuous Positive Airway Pressure

The set value CPAP/PEEP is used to increase the pressure level of respiration in order to raise the functional residual capacity (FRC) of a spontaneously breathing patient. The patient is able to breathe spontaneously without any restriction at the set pressure level. The CPAP mode is used exclusively on patients with adequate spontaneous breathing.

In principle, the pressure is set at the end of expiration (PEEP). The set maximum ventilation pressure (pMax) ensures the safety of the patient.

The following parameters can be set:

  • PEEP: Positive end-expiratory pressure in mbar

  • pMax: Maximum inspiratory pressure in mbar

CPAP is included in MEDUMAT Transport and MEDUMAT Standard². For the MEDUMAT Transport, you use the CPAP + ASB mode, and switch the pressure support ASB off by selecting Δ pASB = 0.

CPAP + ASB / CPAP + PS

Continuous Positive Airway Pressure + Assisted Spontaneous Breathing / Continuous Positive Airway Pressure + Pressure Support

The CPAP + ASB mode can be separated into its individual elements:

  • The set value CPAP/PEEP is used to increase the pressure level of respiration in order to raise the functional residual capacity (FRC) of a spontaneously breathing patient.
  • The ASB function is used for pressure support of insufficient or exhausted spontaneous breathing. The patient is able to breathe spontaneously without any restriction, but is supported in their breathing effort by the device.

The CPAP + ASB mode is used exclusively on patients with adequate spontaneous breathing. In principle, the pressure is set at the end of expiration (PEEP).

If necessary, the pressure support (Δ pASB) can be switched on. Ventilation can be individually adjusted to suit the patient with the aid of the inspiratory and expiratory triggers. The inspiratory trigger indicates a sensitivity for triggering pressure support. The expiratory trigger determines when the device interrupts pressure support.

This allows the administered volume and the inspiratory time to be set indirectly.

The set maximum ventilation pressure (pMax) ensures the safety of the patient.

CPAP + ASB can be used both for non-invasive therapy via mask, as well as on intubated patients.

The following parameters can be set:

  • InTr: Inspiratory trigger

  • Δ pASB: Pressure support (relative to the set PEEP)

  • PEEP: Positive end-expiratory pressure in mbar

  • pMax: Maximum inspiratory pressure in mbar

  • ExTr: Expiratory trigger

CPAP + ASB is included in MEDUMAT Transport and is available in MEDUMAT Standard² if the flow measurement + ASB option is activated.

CPAP + PS has a fixed expiratory trigger which can be set to three levels and is available for MEDUVENT Standard. 

not-invasive ventilation CPAP ASB curve
Demand Flow MEDUMAT Easy CPR

Demand Flow Mode

For MEDUMAT EasyCPR

In the demand flow position, MEDUMAT EasyCPR is switched to breathing-controlled O2 inhalation. Inhalation can be carried out using the ventilation mask. A low inhalation (trigger) pulse causes oxygen to continue flowing until a slight overpressure interrupts the flow; expiration then takes place via the patient valve as in ventilation. Inhalation takes place with the following settings:

  • Trigger: < 1 mbar

  • Peak flow: > 40 l/min

  • Switch-off pressure: 3 mbar

These settings cannot be changed.