Initiation of NIV

Setting up NIV

Different machines and modes work better for different patients.

An individualised approach should be taken when deciding on the machine and mode to trial at initiation with consideration for changing the machine or mode if the patient cannot tolerate it.

At present there is limited evidence on the optimal ventilation settings to use when initiating non-invasive ventilation (NIV). However, it is important that the settings are optimised at initiation to ensure good adherence and effective ventilation. This is because effective ventilation at one-month is associated with improved survival.

Healthcare professionals should make sure that the patient is synchronising with the machine. The settings to use when initiating NIV will be influenced by individual circumstances such as age, weight and CO2 levels. Seek senior support when deciding on the initiation settings to use.

Amending the settings on a NIV machine

NIV display screen

Patients should be monitored regularly during the initiation of NIV, ideally calling the patient every three days until the patient is established on NIV.

Good practice points