TY - JOUR
T1 - Noninvasive ventilation and the upper airway: should we pay more attention?
AU - Oppersma, Eline
AU - Doorduin, Jonne
AU - van der Heijden, Erik H.F.M.
AU - van der Hoeven, Johannes G.
AU - Heunks, Leo M.A.
A2 - Vincent, Jean-Louis
PY - 2013
Y1 - 2013
N2 - In an effort to reduce the complications related to invasive ventilation, the use of noninvasive ventilation (NIV) has increased over the last years in patients with acute respiratory failure. However, failure rates for NIV remain high in specific patient categories. Several studies have identified factors that contribute to NIV failure, including low experience of the medical team and patient–ventilator asynchrony. An important difference between invasive ventilation and NIV is the role of the upper airway. During invasive ventilation the endotracheal tube bypasses the upper airway, but during NIV upper airway patency may play a role in the successful application of NIV. In response to positive pressure, upper airway patency may decrease and therefore impair minute ventilation. This paper aims to discuss the effect of positive pressure ventilation on upper airway patency and its possible clinical implications, and to stimulate research in this field.
AB - In an effort to reduce the complications related to invasive ventilation, the use of noninvasive ventilation (NIV) has increased over the last years in patients with acute respiratory failure. However, failure rates for NIV remain high in specific patient categories. Several studies have identified factors that contribute to NIV failure, including low experience of the medical team and patient–ventilator asynchrony. An important difference between invasive ventilation and NIV is the role of the upper airway. During invasive ventilation the endotracheal tube bypasses the upper airway, but during NIV upper airway patency may play a role in the successful application of NIV. In response to positive pressure, upper airway patency may decrease and therefore impair minute ventilation. This paper aims to discuss the effect of positive pressure ventilation on upper airway patency and its possible clinical implications, and to stimulate research in this field.
KW - BSS-Biomechatronics and rehabilitation technology
KW - NIV
KW - Noninvasive ventilation
KW - Upper airway
UR - http://eprints.ewi.utwente.nl/24525
U2 - 10.1186/cc13141
DO - 10.1186/cc13141
M3 - Article
SN - 1466-609X
VL - 17
SP - 1
EP - 7
JO - Critical care
JF - Critical care
IS - 245
ER -