NIPPV is frequently used in the management of critically ill patients presenting with an acute COPD exacerbation, as NIPPV decreases the rates of intubation and is associated with lower in-hospital mortality. Typically, "low" intensity NIPPV, whereby inspiratory positive airway pressures less than 18 cm H2O are used. More recently, the use of "high" intensity NIPPV, with IPAPs between 20-30 cm H2O, has been shown to improve gas exchange, ventilatory function, and improve arterial PCO2 values. In this podcast, we review the HAPPEN Trial, which compared low intensity to high intensity NIPPV on the need for intubation in patients with an acute COPD exacerbation and hypercapnia.
The administration of IVFs is nearly universal in critically ill patients. In recent years, several studies have suggested improved outcomes with the use of...
More than 1.5 million patients are intubated each year in the United States. In up to 20% of patients, the first attempt at intubation...
More than 3 million patients develop ARDS each year across the globe. Like any therapy, mechanical ventilation can induce further lung injury and cause...