PVI during NIV
NIV has a solid base of evidence for its indications but deserves a considerable amount of attention to keeping the patient comfortable and the interface synchronous. NIV may be under-utilised secondary to suboptimal clinical use.
Potential causes of NIV failure include
- Poor patient selection
- Progression of underlying disease
- Patient-Ventilator-Asynchrony due to:
- Wrong interface (size, leak)
- Wrong ventilator (poor leak compensation)
- Suboptimal ventilator settings
- Clinician inexperience
An asynchrony index (AI) of > 10% is considered severe.
A large leak and a high amount of pressure support are associated with a high AI.