How can the role of noninvasive ventilation (NIV) after extubation be summarized?

Updated: Jun 18, 2020
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Noninvasive ventilation is effective as a bridge support after early extubation.

Noninvasive ventilation is an adjunct to weaning (substitutes noninvasive support for invasive support).

Patients with underlying COPD are most likely to benefit from noninvasive ventilation after early extubation.

Noninvasive ventilation is not as effective in patients with postextubation respiratory distress.

COPD patients are a subgroup who may benefit in that situation.

Preemptive or near-immediate use (as opposed to waiting for respiratory distress) of NIV following extubation may be more effective in the transition of patients off invasive ventilatory support.

HFNC oxygen is an acceptable option for the transition off ventilatory support following extubation.

While postoperative patients may be especially suited to HFNC, it has been successful with other causes of respiratory failure.

The combination of NIV and HFNC is more effective than HFNC alone following extubation in patients with cardiac and respiratory disease.


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