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Motor Neurone Disease What is NIV?

Motor Neurone Disease What is NIV?. Barbara Furnival Clinical Lead Physiotherapy WHH NHS FoundationTrust. NIV. None-invasive ventilation. Also known as BIPAP, Biphasic Positive Airways Pressure. Delivered by a mask onto the face, driven by a portable ventilator,

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Motor Neurone Disease What is NIV?

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  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 patient’s 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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