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Motor Neurone Disease What is NIV?

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Motor Neurone Disease What is NIV? Barbara Furnival Clinical Lead Physiotherapy WHH NHS FoundationTrust NIV None-invasive ventilation. Also known as BIPAP, Biphasic ... – PowerPoint PPT presentation

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Title: Motor Neurone Disease What is NIV?


1
Motor Neurone DiseaseWhat is NIV?
  • Barbara Furnival
  • Clinical Lead Physiotherapy
  • WHH NHS FoundationTrust

2
NIV
  • None-invasive ventilation.
  • Also known as BIPAP, Biphasic Positive Airways
    Pressure.
  • Delivered by a mask onto the face, driven by a
    portable ventilator,
  • NOT from a tube into the airway (endotracheal
    intubation- tube into the mouth, or tracheal
    intubation- tube into the trachea as a result of
    surgical procedure). This is formal ventilation.

3
NIV
4
Why do MND Patients need NIV?
  • Breathing Difficulties.
  • 3 main muscle groups are responsible for
    healthy respiratory function
  • inspiratory muscles.
  • upper airway muscles.
  • expiratory muscles.

5
Effects of Weakness of Muscle Groups.
  • Inspiratory,( breathing in) results in
    ventilatory failure.
  • Upper airway,results in swallowing difficulties.
  • Expiratory, (breathing out) results in weak
    cough, with retention of secretions-infections.

6
Symptoms
  • Breathlessness on exertion (dyspnoea).
  • Breathlessness when lying down (orthopnoea).
  • Morning headaches.
  • Extreme fatigue.
  • Excessive daytime sleepiness.
  • Disturbed sleep.

7
Signs.
  • Reduced chest expansion.
  • Rapid respiratory rate.
  • Accessory muscle recruitment.
  • Weak cough.
  • Weak sniff.
  • Paradoxical movement of the abdomen on
    inspiration.

8
NIV Pros and Cons
  • Not ideal for everyone, Physician must assess and
    lead on treatment choices.
  • Initially ventilated overnight.
  • Does extend life by an average of 12 months.
  • Does NOT halt/regress disease progression.
  • Alleviates most of the respiratory symptoms
    initially.
  • Dependency on NIV extends into the day.
  • Creates strain on family/carers.

9
What is Cough Assist?
  • In-sufflator, ex-sufflator.
  • Mechanical device that stimulates a cough.
  • Inspiratory pressure is delivered from the device
    via a mask/mouth-piece into the patients mouth.
  • Expired air sucked back through interface,
    causing a cough.
  • Patient expectorates.
  • This reduces risk/impact of chest infection.

10
Cough Assist
11
Workshops
  • Come to our workshop to
  • Learn more about the NIV
  • Learn more about the cough assist
  • Have a try of the equipment
  • Ask questions
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