What is NIV and what does it do?
Non-Invasive Ventilation (or NIV) is a machine that assists your breathing by blowing extra air into your lungs via a mask.
NIV helps to:
- Support your breathing
- Rest your breathing muscles
- Give you time to recover
- Supply you with the oxygen you need
- Get rid of the waste carbon dioxide
An example of an NIV machine and face mask:
ResMed Ltd©
Chronic Obstructive Pulmonary Disease (COPD)
From time to time this condition can get worse and cause breathing difficulties. Oxygen levels in the blood may become low and in turn, carbon dioxide levels go too high. This is called Type 2 Respiratory Failure. This can cause extreme drowsiness, you may become acutely unwell and in some situations, it can be fatal.
Some other reasons for needing NIV are:
- Sleep apnea
- Deformities of the upper body
- Obesity
- Chest wall disorders
- Neuromuscular disorders
- Other pulmonary diseases
National Guidelines show that NIV (Non Invasive Ventilation) is the correct treatment for someone suffering Type 2 Respiratory Failure.
How do you know that I need NIV?
A nurse or doctor will take a blood sample from the inside of your wrist, known as an arterial blood gas. This can be uncomfortable but does not take too long. This blood test will show us the exact level of oxygen and carbon dioxide in your blood, allowing us to determine the right source of treatment.
We may try several routes of treatment to prevent needing NIV, however, should you still need it, you may have a few blood gases taken to allow us to monitor your levels closely and ensure you are improving.
What happens when I use the NIV machine?
- A breathing mask is connected to a small machine beside your bed
- A nurse will ensure you wear the correct size mask , this can be tight and uncomfortable, but nurses will try and reassure you at all times
- The mask is applied firmly to the face to try to stop air leaking out
- It supports your breathing to help you to relax and get some sleep
- NIV can feel strange at first, but most patients adjust quickly
- Sometimes the machine may beep or make an alarm sound – these tell the nurse if the machine and mask are working properly
- A small probe will be placed on a finger to test your oxygen levels
The machine will recognise your normal breathing pattern, so it is important to try to relax. Once the machine and your breathing pattern work together it will become more comfortable and easier to tolerate.
How long will I have to be on the machine?
At the start, you will be encouraged to wear the mask as much as possible. The first few hours are critical; however, it is very important to stay on the NIV machine for as long as possible in the first 24 hours as this increases your chances of a quick recovery. The nurses can facilitate short breaks from the mask for meals, drinks, medications and to use the toilet. A hand held nurse call button will be given to you so that you can ask for assistance.
If NIV is working well then the mask will be used less and less over the next few days and nights, until it is only used overnight. You can recover more effectively if you are weaned off the NIV over a few days. If NIV is stopped early you may relapse and become unwell again, meaning the treatment will last longer.
Where will I receive the NIV treatment?
You may receive treatment in Accident and Emergency, the Emergency admissions ward (1&2), on Ward 9 (respiratory ward) or in the Critical Care Department. Nurses are highly trained in the use of NIV, and we have portable machines that can be used across the hospital.
How successful is NIV?
NIV treatment has a good success rate. However, success can also depend on other things:
- Whether you tolerate the machine well over a good period of time
- The severity of lung disease prior to the treatment
- If you already have an infection, illness or another disease
When starting NIV, a discussion will be held with doctors to create a medical management plan in case your condition deteriorates.
Overall, if tolerated well, positive outcomes are common for patients who have had NIV.
Do I have a choice?
You have a choice to have NIV treatment or not. If you don’t want this treatment you will still be provided with excellent care and will receive any other treatment you may need while in hospital.
Any questions you have can be answered by your NIV nurse who will introduce themselves before your treatment starts.
Further information
British Lung Foundation: https://www.blf.org.uk
NHS Choices: http://www.nhs.uk/
Contact details
Telephone number for Ward 9: 0191 445 2009
Vocera NIV Nurse