What Are the Types of Noninvasive Ventilation? COVID-19

Invasive ventilation: The type of ventilation where oxygen is delivered to your lungs through a tube inserted into your nose or throat (endotracheal tube or tracheostomy tube) that goes into your windpipe.

A ventilator is a machine that helps in delivering oxygen to your lungs. It is used to assist with breathing when you cannot breathe on your own. The ventilator is usually connected to your nose through a pipe-like structure, and this process of assisted breathing is known as mechanical ventilation.

There are two types of ventilation:

• Invasive ventilation: The type of ventilation where oxygen is delivered to your lungs through a tube inserted into your nose or throat (endotracheal tube or tracheostomy tube) that goes into your windpipe.
• Noninvasive ventilation: Noninvasive ventilation (NIV) is the administration of ventilatory support without using an invasive artificial airway (endotracheal tube or tracheostomy tube)

You may require noninvasive ventilation when you can’t breathe properly for the following conditions:

• Chronic obstructive pulmonary disease (COPD): Long-term diseases like chronic bronchitis and emphysema in which there is excessive coughing, increase in respiratory rate, and difficulty in breathing
• Cardiogenic pulmonary edema: Fluid build-up in the lungs due to cardiac disease
• Respiratory muscle weakness
• Ventilator-associated pneumonia
• Sleep apnea (cessation of your breathing in sleep)
• COVID-19: Only those patients with the most severe symptoms of COVID-19 need noninvasive ventilation.

The use of noninvasive ventilation offers the following advantages:

• Reduces the work pressure on longs 
• Eliminates the need for endotracheal intubation or a tracheotomy, avoiding their complications
• Reduces the chances of infections
• Improves the chances of survival 
• Reduces your hospital stay

You can resume activities like talking, eating, and taking medications. It does not require hospital supervision.

There are two types of noninvasive ventilation:

• Positive-pressure ventilation:
  • It pushes the air into the lungs. 
  • Two types of positive pressure ventilation are used in sleep apnea—Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Pressure(BiPAP). 
  • Your doctor will decide which one is suitable for you.

• Negative-pressure ventilation: 
  • It sucks the air into the lungs by expanding and contracting the chest through a device that wraps the chest. 
  • This method of ventilation is hardly used nowadays.

The most commonly used noninvasive ventilation is a positive-pressure type. It helps in delivering oxygen to your lungs through a mask fitted tightly around your face or head in the following way:

• The ventilator pushes the oxygen from the oxygen cylinder into the patient’s airway via your face/head mask. 
• The settings of the ventilator are adjusted in such a way that they regularly blow air into the patient’s airway and stop. 
• This cycle gets repeated which helps the patient in inhaling oxygen in the body and expelling carbon dioxide from the body.

Your doctor might give you sedatives to help you drowsy or medicines to lower your anxiety.

• You will be positioned at a 30-90-degree angle upright in your bed.
• A face mask or head mask will be fitted on your entire face or head tightly.
• A strap will be connected to your face mask to maintain its position.
• The oxygen cylinder will be attached to the ventilator.
• Your face mask will be connected to the ventilator, which will be adjusted on an adequate pressure of oxygen by your doctor.

Most complications are mild and happen with long-term use. These include:

• Ulcers at the attachment of the face mask
• Eye irritation and pain
• Congestion of the nasal sinuses

Other complications include:

• Bloating of stomach
• Aspiration (sucking of food into the lung)
• Hypotension (low blood pressure)