Non Invasive Mechanical Ventilation

By Junaid Malik MD D. ABSM

This book was initially started to help with understanding and organizing what I needed to know about the two most common NIMV (noninvasive mechanical ventilation) units, ie. Trilogy and Astral. As I presented this information at various lectures, it was clear to me that there was no guide that could be used in the setup of these machines. The most common mode of ventilation in each was AVAPS and iVAPS, respectively. Most of the initial difficulty is getting into the main menus of the machines. Once this is accomplished, one can easily change and adjust each of the machines. My hope is to impart the knowledge I have gained out of necessity to others. The hope is to have a step-by-step method of entering the menu and then moving through the various settings. I have concentrated on the two main modes of ventilation on each of the machines as the other modes available are variations on the two main modes. As one understands and allows for more experience with these machines, it will hopefully allow for more expertise in these field.

In the NIMV clinic, I have patients sit in a recliner, and then, I place them on these machines with a mask of the patient’s choosing. Then based on trial and error, I start adjusting the pressures. Once the pressures and settings feel right to the patient, I allow the patient to recline and take a small nap. While they are napping, I have a continuous pulse oximetry, which can be added to these machines to monitor the oxygen saturation. By the end of the clinic, I have the exact settings and give this to the DME (durable medical equipment) company. In follow up, I know exactly what the settings are and if they are tolerable to the patient.

• Language: English
• Publisher: Xlibris US
• Release date: Dec 6, 2018
• ISBN: 9781984568779

Book preview

Copyright © 2018 by Junaid Malik, MD, D. ABSM. 786610

Library of Congress Control Number: 2018914079

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Rev. date: 12/03/2018

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TABLE OF CONTENTS

Chapter 1: Introduction

Chapter 2: The Mask

Chapter 3: Where Can You Use the NIMV?

Chapter 4: The Machines: CPAP or Bilevel

Chapter 5: Advanced Assured Ventilation

Chapter 6: Troubleshooting

CHAPTER 1

I find it very interesting over years of practice to find sleep physicians or pulmonologists who prescribe positive airway pressure (PAP) therapy and not be able to actually change or look at the machines that they give to their patients. As technology advances, the provider has delineated this task to a durable medical equipment (DME) company, who tends to have a respiratory therapist or (at least) a driver to set up the patient with these PAP therapies. This is equivalent to going to a computer store to buy a computer and the sales representative does not even know how to turn on the computer you are about to purchase.

Technology advances, and learning these PAP or noninvasive mechanical ventilation (NIMV) devices is becoming more demanding; however, as a physician, this is as important as learning the next new electronic medical system. It is not