Monitoring Astronauts’ Status through Non-Invasive Positive Pressure Ventilation

Salt Lake Community College Student Center

Many hospitalized patients with respiratory failure are treated with non-invasive positive pressure ventilation (NiPPV). In many cases non-invasive ventilation can be used to successfully treat patients and subsequently avoid endotracheal intubation. Recent literature and clinical practice have shown that in patients who are protecting their airway, and in whom the pH is not dangerously low, the use of non-invasive positive pressure ventilation can be effective (1). Additional studies argue that NiPPV in more severely ill patients (pH < 7.2) with chronic obstructive pulmonary disease (COPD) is no worse than endotracheal intubation (2,3) with regard to mortality, lengths of stay and readmission rates. Furthermore, better outcome was confirmed for patients who succeeded NiPPV and avoided endotracheal intubation. Thus, the non-invasive mode of ventilation can assist patients in ventilating equally or more effectively, and in many cases can be used to avoid the more invasive endotracheal intubation. Many studies have evaluated treatment failures of NiPPV. Failure rates range from 30-80% depending on the cause of respiratory failure and underlying medical condition(s) of patient population (4). Other studies have looked at factors which predict NiPPV failure, such as physiologic scoring (age, severity of underlying illness) and presence of acute respiratory distress syndrome (ARDS) or community acquired pneumonia (CAP) (5). Having an objective and real time means of early identification of patients that will fail NiPPV would greatly benefit patients by helping physicians intervene early with endotracheal intubation when indicated.