8 - Pediatric NIV

purpose of non-invasive ventilation (NIV)

support ventilation and oxygenation without artificial airway

methods of NIV

nasal prongs/mask

goals of NIV

• restore FRC

• reduce WOB

• stabilize alveoli

forms of NIV

• CPAP

• BiPAP

• non-invasive inspiratory ventilation (NIIV)

purpose of CPAP

alveolar recruitment, prevent alveolar collapse

indications for CPAP

• respiratory drive

• preterm

• mild distress

• post-extubation

usual CPAP levels

5-8 cmH₂O

inspiratory NIV (NIIV)

positive pressure during inspiration to reduce WOB

indications for NIIV

• respiratory insufficiency

• bronchiolitis

• asthma

• neuromuscular disorder

goals of NIIV

• increase FRC

• improve C_L

• V/Q matching

contraindications for NIV

• severe respiratory failure

  • P_aCO₂ > 65

  • pH < 7.25

• frequent/severe apnea

• untreated pneumothorax

• craniofacial abnormalities

• tracheoesophageal fistula

• unrepaired CHD

• gastric insufflation or aspiration risk