Non invasive Ventilation

Lynn Mac Isaac

BC Children’s Hospital
Vancouver, BC
 Optimal Humidity

High flows delivered comfortably

through a unique nasal cannula
interface

Optimized Positive airway Effective oxygen Washout of anatomical

mucociliary pressure during the delivery dead space
clearance respiratory cycle
Delivering Optimal Humidity, 37 °C, 44 mg/L,
optimizes mucociliary clearance6,7,8
Improved secretion quality
Maintenance of the mucosal function
Secretions remain mobile for transport out
of the airway

Prevents insensible heat loss

Prevents changes in Nasal Airway

Resistance
 The flow delivered with Nasal High Flow aims
to meet or exceed the patient’s Inspiratory
demand:
◦ Room air entrainment is minimized
◦ Dilution of prescribed oxygen and humidity is reduced
◦ Oxygen delivery can be precisely controlled
 Approx. Max. Quant
rt No. Description
Weight Flow ity
OPT3 Premature size nasal
<2 kg 8 L/min 20/box
12 cannula
OPT3 Neonatal size nasal
1-8 kg 8 L/min 20/box
14 cannula
20
OPT3 Infant size nasal
3-15 kg L/mi 20/box
16 cannula
n
25
OPT3 Pediatric size nasal
12-22 kg L/mi 20/box
18 cannula
n
Pediatric BiPAP

 Synchronizes pressure level changes:

◦ higher pressure on inhalation
◦ lower pressure on exhalation

 Provides CPAP
 For
larger infants (e.g., chronic
neuromuscular disease, upper airway)
 Approved for >30 kg
 Small children will not be able to trigger
 Set back up rate of 20 bpm
 New devices on market approved for 5kg and

up
 2012 number of patient’s
0n non-invasive ventilator
at home 296 patient’s in
British Columba
BiPAP
At least once a Shift assessment…
 Remove prongs/mask and hat
 Assessment of septum, bridge, nares and

upper lip
 Suction gently of nares and mouth
 Clean the skin gently
 Clean equipment as needed
 Document findings
Q hour…

 Perform the “LIFT/DROP” check to look

for signs of skin breakdown and to
check skin integrity
 Oral gastric tube:
 Leave to open barrel

 Aspirate prior to feeds or prn

 Does the infant need suctioning?
 Aspirate any gastric air?

 Try positioning prone → can help relieve

abdominal distension and diaphragmatic

pressure
 “Hands off” approach as the infant settles

 Minimal handling
 Pace care (vs cluster care)