Interface in Noninvasive Ventilation in Hypoxemic Respiratory Failure: Summary and Practical Recommendations

ABSTRACT

Noninvasive ventilation (NIV) by helmet or mask is increasingly being used for treatment of patients with acute hypoxemic respiratory failure (ARF) of varied etiologies. Although the first significant data of benefit from NIV comes from studies performed in Intensive Care Units, subsequently these methodologies have been used with increasing frequency in Emergency Departments and Medical Wards. Despite the overall success of NIV, failure rates still occur in clinical settings such as for acute asthma, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and severe pneumonia. Acceptance of the interface by the patient is crucial for successful treatment. Poor cooperation with the interface from onset of treatment will hamper NIV effectiveness. That’s why interface choice is essential from the beginning. Offering various interface models and sizes may enhance compliance for those who might not adapt well to one but might comply with another. In this context, the role of a properly trained nursing staff becomes essential for the success of NIV. Helmet and mask NIV are recommended treatments for hypoxemic ARF in general. Recent data on avoidance of intubation and improvement in outcomes are conflicting for patients with moderate or severe ARDS, for which further investigations are needed. In COVID-19 respiratory failure, healthcare professionals not only have to determine the best treatment, but also eliminate virus transmission. The administration of NIV via helmet or mask seems to improve oxygenation and decrease need for intubation for patients with COVID-19 pneumonia in hypoxemic ARF. Just as importantly, with COVID-19 being extremely contagious, it is vital to adhere to the infection control measures of the policies of hospitals, health departments, recommendations from WHO and the Centers for Disease Control and Prevention to limit viral transmission during NIV therapy. © 2022 by Nova Science Publishers, Inc. All rights reserved.