NIV is used in a number of medical conditions, most commonly in COPD exacerbation. COPD patients are at risk of developing decompensated carbon dioxide retention exacerbation. Early NIV can help to alleviate the problem and can lead to a better outcome.
Choosing the right patient needing NIV would the most important 1st step rather than the initial setting or mechanics of the machine. Fulfilling expectations of both the physicians, patient and families and limitation of what NIV can or cannot achieve including the possible next step or consideration what might be the ceiling of care should be planned ahead.
Instructions concerning the setting, titration, sampling of blood gases, patient conscious level should be clear. Patient nutrition is often ignored, possible pressure damage from the mask and even having pressure relieving mattress preventing bed sores are frequently forgotten.
Teamwork is key to achieve the best possible outcome for the patient.