Editing Breathing (section)

== '''NIV (BIPAP - bilevel positive airway pressure)''' ==

* Useful in type 2 resp failure to prevent or treat CO2 retention
* High pressure during inspiration (about 20cm H2O), lower pressure during expiration (5cm H2O)
* The pressure difference generates gas flow into the lungs during inspiration
* Not appropriate if CV unstable, decreased GCS, severe metabolic acidosis, low RR, unco-operative
* NGT usually required to reduce gastric distension
* '''If CO2 doesn't improve within 30 mins, it probably won't work'''
* Generally requires critical care support
* Failing to tolerate:
** Refractory hypoxaemia
** Increased RR
** Progressively smaller tidal volumes with worsening CO2 retention