English
Invasive And Non Invasive Respiratory Support In Mukundapur, Kolkata - Manipal Hospitals

Invasive and Non-invasive Respiratory Support

Invasive and Non-invasive Respiratory Support in Mukundapur, Kolkata

Respiratory support in the Paediatric Intensive Care Unit encompasses a wide range of interventions, from non-invasive oxygen delivery to invasive mechanical ventilation. With caution against indiscriminate oxygen use, the importance of delivering oxygen within well-defined clinical target ranges is emphasised to mitigate reperfusion injuries. 

  • For mild to moderate respiratory distress, early adoption of continuous positive airway pressure (CPAP) has shown benefit. High-Flow Nasal Cannula Therapy (HFNC) is emerging as an alternative, offering inspiratory support, oxygen delivery, and positive expiratory pressures without the need for complex equipment or child compliance.

  • Additionally, the use of non-invasive ventilation methods such as CPAP or bi-level positive airway pressure ventilation has increased, particularly showcasing efficiency in older children with asthma in emergency settings.

If you are looking for Invasive and Non Invasive Respiratory Support in Mukundapur, Manipal Hospitals' team of doctors having expertise in delivering efficient results can be approached. 

FAQ's

  • NRS offers ventilatory assistance without the need for invasive airway procedures.

  • Patients who are susceptible to respiratory distress might use it as a preventative measure or as a treatment.

  • Two popular varieties are non-invasive positive pressure ventilation (NPPV) and nasal continuous positive airway pressure (NCPAP).

  • Constant airway pressure is maintained with NCPAP, which helps with oxygenation and lessens breathing effort.

  • By providing regulated or aided ventilation, NPPV enhances gas exchange and the unloading of respiratory muscles.

  • NPPV is useful in lowering inspiratory effort and enhancing gas exchange and breathing patterns, according to recent research.

Invasive mechanical ventilation, often facilitated through endotracheal tube insertion, stands as a primary method for managing critical respiratory conditions and is a frequent cause of Intensive Care Unit (ICU) admissions. Multinational studies have demonstrated the necessity of its application in a variety of medical circumstances. These comprise acute respiratory distress syndrome (ARDS), heart failure, trauma, pneumonia, sepsis, chronic obstructive pulmonary disease (COPD), surgical complications, and neuromuscular problems. Every indication highlights the wide spectrum of circumstances in which invasive ventilation becomes necessary to ensure appropriate respiratory support and patient stabilisation in the Intensive Care Unit.
 

Hypoxemic respiratory failure features low blood oxygen levels and normal or low carbon dioxide levels. It's typically due to uneven ventilation-perfusion matching in the lungs.

Causes

  • Pneumonia: Mainly caused by Streptococcus pneumoniae, leading to lung volume reduction.

  • Bronchiolitis: Common in children under 2 years, often due to respiratory syncytial virus, causing increased airway resistance and lung volume reduction.

  • ARDS: Both pneumonia and bronchiolitis can progress to acute respiratory distress syndrome (ARDS).

Ventilation may be indicated in critically ill patients for various reasons, including:

  • Increasing the breathing rate

  • Irregular respiration pattern

  • Shift in awareness and consciousness

  • Frequent desaturation of oxygen despite rising levels of oxygen

  • Respiratory acidosis and hypercapnia

  • Issues with the circulation, such as atrial dysrhythmias and hypotension

  • Patients who become extremely ill should be identified early to prevent major cardio-respiratory decompensation

Infants:

  • Frequent and severe apneas

  • Unrepaired congenital diaphragmatic hernia

  • Gastric insufflation

  • Tracheoesophageal fistula

  • Cranial facial abnormalities, preventing interface application

  • Untreated pneumothorax

  • Neuromuscular disorders with severe respiratory depression

Children:

  • Acute moderate-to-severe ARDS with respiratory failure

  • Untreated pneumothorax

  • Facial injuries

  • Traumatic injuries

  • Burns

  • Risk of aspiration (consider interface; nasal mask may be acceptable)

  • Severe haemodynamic compromise and cardiovascular instability

  • Patients undergoing certain upper-gastrointestinal tract surgeries

  • Patients with increased intracranial pressure (evaluate risk-benefit)

  • Physicians determine whether to use a timed, spontaneous, or spontaneous/timed breathing mode

  • Patient-specific initial settings necessitate patience

  • Tolerance and efficient triggering depend on the choice of patient interface

  • Based on oxygen saturation, the EPAP (expiratory positive airway pressure) setting should be modified to avoid alveolar collapse

  • The goal of the IPAP (inspiratory positive airway pressure) setting is to remove CO2 and expand the chest enough

  • Breath delivery should be possible with an adequate inspiratory time that does not hurt

  • For the comfort and effectiveness of the patient, secondary variables such as trigger sensitivity, rise time, cycle time, and ramp time should be changed

When non-invasive techniques are unable to sustain sufficient gas exchange and respiratory function, invasive respiratory assistance becomes necessary for severely sick patients. 

The key indications include:

  • Major trauma or high-risk surgeries

  • Uncontrolled airway secretions

  • Severe haemodynamic instability

  • Inability to protect the airway

  • Respiratory muscle fatigue

  • Severe metabolic or respiratory acidosis (pH < 7.2)

  • Severe hypoxemic (PaO2 < 60 mmHg) or hypercapnic (PaCO2 > 50 mmHg) respiratory failure

  • Ability to facilitate critical procedures such as Bronchoscopy 

Patients who are unable to maintain appropriate ventilation are supported by invasive mechanical ventilation. These are the common types:

  • Airway pressure release ventilation (APRV) for ARDS

  • High-frequency oscillatory ventilation (HFOV) for severe ARDS

  • Pressure-controlled ventilation (PCV) for poor lung compliance

  • Synchronised intermittent mandatory ventilation (SIMV) for weaning

  • Pressure support ventilation (PSV) for spontaneous breaths

  • Assist-control ventilation (ACV) for full support

  • Pressure-regulated volume control (PRVC), which combines volume and pressure control to minimise injuries

Every kind is designed to meet certain breathing requirements.
 

Invasive mechanical ventilation helps maintain gas exchange and equilibrium in the respiratory system. Maintaining pressure-volume relationships (tidal volume, PEEP, PIP), controlling lung mechanics (compliance and resistance), assuring oxygenation and ventilation, and employing the proper ventilation modes (volume-controlled, pressure-controlled, support modes) are important concepts. Breathing becomes easier, patient-ventilator synchronisation (smooth cycling, trigger sensitivity) is guaranteed, haemodynamic effects are taken into account, and constant monitoring and changes are needed to maximise therapy and avoid problems in critically ill patients.
 

Complications of noninvasive respiratory support (NIV) in children and infants include pressure ulcers, aspiration, stomach distention, and pneumothorax. Pressure ulcers, which range from superficial skin discolouration to deep-tissue damage, are the most preventable. Avoiding stomach distention can be helped by using vented gastric tubes. Aspiration risk can be reduced through careful suctioning, head-of-bed elevation, and feeding control. Monitoring chest rise and pressure delivery helps minimise pneumothorax risk. Close observation and proactive measures are crucial during NIV treatment for paediatric patients to mitigate these complications.
 

Home Mukundapur Specialities Paediatric-intensive-care-unit Invasive-and-non-invasive-respiratory-support

Appointment
Health Check
Contact Us
review icon
Review Us
Call Us