What is NIV?
NIV stands for Non-Invasive Ventilation. It is a way of supporting your breathing by using a bedside machine and tight fitting mask that sits over your nose and mouth. By supporting you with your breathing it improves the effectiveness of your lungs by reducing the amount of carbon dioxide in your blood and improving oxygenation whilst allowing your body to rest.
Why do I need it?
NIV is used when your breathing has become increasingly difficult, possibly due to an infection, to the point that your lungs are no longer carrying out their job effectively. This then leads to a build-up of carbon dioxide and a lack of oxygen in your blood. This causes your blood to become acidic and can lead to respiratory failure.
This can often happen to those who have an existing lung condition such as Chronic Obstructive Pulmonary Disease (COPD) but it can also affect those who are overweight or have weakened breathing muscles.
If left untreated the build-up of carbon dioxide in the blood can be very dangerous but NIV has been proven to be an effective treatment given to patient that corrects those levels.
Symptoms you may feel or experience before needing NIV can include:
- worsening breathlessness
- tightness in your chest
- inability to concentrate
- a sense of confusion
- increase drowsiness
What is involved?
To see if NIV is appropriate a blood test from your artery in your wrist will need to be taken. This is called an Arterial Blood Gas (ABG). These tell us if your blood is acidic and the amount of oxygen and carbon dioxide in your blood. ABG tests are used as a way to monitor your condition and ensure that the NIV is working and so you will likely need more than one.
How does it work?
NIV involves wearing a tight fitting mask which is connected to a machine and oxygen if needed. The machine forces air into your lungs to enable the exchange of carbon dioxide and oxygen in your blood. The mask is designed to “bounce” on your face but it still needs to be tight to stop any leaks and to be effective.
NIV can take several days to work but as your condition improves you will need less ABG tests and you will be able to spend more time off the machine. NIV is usually worn for at least three days but as every patient is different it maybe decided that you need NIV for longer or shorter length of time. This will be your consultant’s decision.
Whilst you are on NIV the nursing staff will keep a close eye on you and monitor your condition closely. This may mean wearing a probe on your finger so that your oxygen levels can be closely monitored. For the first 24 hours it is recommended that you wear the mask as much as possible with short breaks for food, drink and medications.
A member of the physio team may also see you during your stay as they can provide advice on breathing techniques, help you to clear your chest and assess your mobility if needed.
What are the side effects of BIPAP?
As with any medical treatment there can be side effects from receiving NIV.
The most common side effect is a sore nose or face. If this happens please tell the staff as a little dressing can be applied to protect the skin
It can also cause a dry mouth so it is important that you drink plenty when off the machine. If you are unable to do so IV fluids can be prescribed if appropriate.
Patients can also feel claustrophobic whilst wearing the mask. This is normal and all we ask is that you give the mask a try!
Ongoing care and discharge planning
As your condition improves and your blood results normalise your medical team will start to plan your discharge. As part of this process they may discuss with you if you were to need NIV again would you want it and if home oxygen is something that is appropriate for you.
Your medical team may also discuss if having NIV at home would benefit you in which case a referral to the North East Home Ventilation Service (NEAVS) at Newcastle maybe needed. Depending on your need they may see you in hospital or as an outpatient
Support and additional information
For extra information you can go to the British Lung Foundation website www.blf.og.uk or contact your local respiratory or COPD nurses
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302