Noninvasive Mechanical Ventilation in Acute Respiratory Failure Patients: A Respiratory Therapist Perspective



V Hidalgo 1, C Giugliano-Jaramillo 1, R Pérez 1, F Cerpa 1, H Budini 1, D Cáceres 1, T Gutiérrez 1, J Molina 2, J Keymer 1, C Romero-Dapueto*, 1
1 Servicio de Medicina Física y Rehabilitación, Clínica Alemana de Santiago, Santiago, Chile
2 Escuela de Kinesiología, Universidad del Desarrollo, Santiago, Chile


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© Hidalgo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Servicio de Medicina Física y Rehabilitación, Clínica Alemana de Santiago, Avenida Vitacura 5951, Vitacura, Santiago, Chile; Tel: +56222101421; Fax: +56222101421; E-mail: cromerod@alemana.cl


Abstract

Physiotherapist in Chile and Respiratory Therapist worldwide are the professionals who are experts in respiratory care, in mechanical ventilation (MV), pathophysiology and connection and disconnection criteria. They should be experts in every aspect of the acute respiratory failure and its management, they and are the ones who in medical units are able to resolve doubts about ventilation and the setting of the ventilator. Noninvasive mechanical ventilation should be the first-line of treatment in acute respiratory failure, and the standard of care in severe exacerbations of chronic obstructive pulmonary disease, acute cardiogenic pulmonary edema, and in immunosuppressed patients with high levels of evidence that support the work of physiotherapist. Exist other considerations where most of the time, physicians and other professionals in the critical units do not take into account when checking the patient ventilator synchrony, such as the appropriate patient selection, ventilator selection, mask selection, mode selection, and the selection of a trained team in NIMV. The physiotherapist needs to evaluate bedside; if patients are properly connected to the ventilator and in a synchronously manner. In Chile, since 2004, the physioterapist are included in the guidelines as a professional resource in the ICU organization, with the same skills and obligations as those described in the literature for respiratory therapists.

Keywords: Acute respiratory failure, noninvasive mechanical ventilation, physioterapist, respiratory therapist.