Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2020
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2021
    • 2020 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Portugûes
    • 国语

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2020
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2021
    • 2020 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Portugûes
    • 国语
  • Follow aarc on Twitter
  • Visit aarc on Facebook
Research ArticleConference Proceedings

Physiologic Effects of Noninvasive Ventilation

Neil R MacIntyre
Respiratory Care June 2019, 64 (6) 617-628; DOI: https://doi.org/10.4187/respcare.06635
Neil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Fig. 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 1.

    Relationship of alveolar ventilation to alveolar PO2 and PCO2 and to the ultimate SaO2 and PaCO2 with an assumed oxygen consumption of 250 mL/min and CO2 production of 200 mL/min. The shaded area represents a normal alveolar ventilation. Note that as alveolar ventilation increases, alveolar PCO2 decreases exponentially, and PaCO2 follows. In contrast, as alveolar ventilation increases, the alveolar PO2 increases and approaches the inspired PO2. However, because hemoglobin saturation is virtually complete at PO2 values > 70–80 mm Hg, arterial oxygen content rises little at alveolar PO2 above this. Data from Reference 10.

  • Fig. 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 2.

    Pressure-volume plots illustrating loading and unloading ventilatory muscle with positive-pressure breaths. Pressure is on the horizontal axis, and volume is on the vertical axis. The solid diagonal line represents the passive respiratory system compliance. Pressures to the left of this line are patient-generated, and pressures to the right of this line are machine-generated. The area of the pressure volume plot represents work (shaded for patient work, open for machine work). A: Represents a normal subject with normal work. B: Represents a diseased patient with excessive work. C: Represents the same diseased patient being totally unloaded by a machine breath (ie, no patient work). D: Represents the patient only doing enough work to trigger a machine breath that provides most of the work to breath. E: Represents the patient and the ventilator interacting to share the work in a fashion that resembles the normal subject work pattern in A. F: Represents a poorly interactive breath in which inadequate unloading by the machine produces excessive loading of the patient. Conceptually, E would seem ideal. From Reference 41, with permission.

  • Fig. 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig. 3.

    Noninvasive ventilation (NIV) has effects on the ventilatory control center (VCC) in the brainstem. The VCC has an intrinsic pattern generator with important inputs from gas exchange sensors and from mechanical load sensors. The output from the VCC controls ventilatory muscle inspiratory muscle intensity and timing. Importantly, this output can be modulated by cortical influences and drugs, an effect sometimes referred to as a loop gain. Positive-pressure NIV can affect the VCC in a variety of ways that include beneficial (and sometimes harmful) effects on gas exchange, ventilatory muscle loading, and even cortical influences that are affected by the sense of dyspnea/anxiety. CRS = compliance of the respiratory system; Raw = airway resistance.

PreviousNext
Back to top

In this issue

Respiratory Care: 64 (6)
Respiratory Care
Vol. 64, Issue 6
1 Jun 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Physiologic Effects of Noninvasive Ventilation
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Physiologic Effects of Noninvasive Ventilation
Neil R MacIntyre
Respiratory Care Jun 2019, 64 (6) 617-628; DOI: 10.4187/respcare.06635

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Physiologic Effects of Noninvasive Ventilation
Neil R MacIntyre
Respiratory Care Jun 2019, 64 (6) 617-628; DOI: 10.4187/respcare.06635
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • NIV Can Augment Minute Ventilation
    • NIV Unloads Ventilatory Muscles
    • NIV Resets the Ventilatory Control System
    • Alveolar Recruitment and Gas Exchange
    • Other Physiologic Effects of NIV: Intended and Unintended
    • Summary
    • Discussion
    • Footnotes
    • References
    • References
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • invasive ventilation
  • noninvasive ventilation
  • minute and alveolar ventilation
  • ventilation distribution
  • ventilation-perfusion matching
  • control of ventilation
  • ventilatory muscles
  • work of breathing
  • patient–ventilator interactions
  • ventilator-induced lung injury

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About Us
  • Editorial Board
  • Reprints/Permissions

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire