NIMV and trauma

[Super RT]

We have seen an increased use of NIMV in our unit and I just worry about the physiologic trauma associated with slamming pressure into the vocal cords like that. I worry about swelling and malcias in the future. Has anyone seen adverse effects associated with it?

[dawngloves, BSN, RN]

Not that I'm aware, but good point! What kind of settings are you using to start off with?

We've also increased our use of NIMV, (big hurry to extubate anymore) but we see your usual breakdown of the nares and septum. Also, we've had an increase in NEC. Hmm.....

[Finallyat40]

Just curious....Is NIMV the same as or simillar to SNIPV? I've had the same concerns about the septums in these kiddos, especially since they are typically the ones who will hang out on CPAP for awhile.....We've also seen more NEC...I asked a couple of attendings if they thought there was any correlation....no good answers yet.

Jamie

[Super RT]

Not that I'm aware, but good point! What kind of settings are you using to start off with?

We've also increased our use of NIMV, (big hurry to extubate anymore) but we see your usual breakdown of the nares and septum. Also, we've had an increase in NEC. Hmm.....

Usually starts with low settings, but I've seen the pressures get up pretty high. We also have seen a higher rate of NEC. I imagine the increased amount of air/pressure in the gut could lead to this. I wonder if there are any ongoing studies about this right now.

What is SNIPV? I've never heard of that. Maybe we call it something else.

[dawngloves, BSN, RN]

Is it just me, or is there little advantage of NIMV?

I have seen more kiddos reintubated from NIMV than if they waited and went on CPAP.The trauma to the nose is worse than with CPAP. I don't think there's a study, but I bet we're onto something with the NEC.And if you can get tracheamalacia with either NIMV or prolonged intubation, what is the point here?