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Table 2 Clinical aspects of Non-Invasive Ventilation in Interstitial Lung Diseases

From: Management of acute respiratory failure in interstitial lung diseases: overview and clinical insights

Problem Tip for solution
High pressures required to obtain ideal tidal volume in fibrotic lung with risk of pneumothorax - Tolerate low tidal volumes with higher respiratory rate to obtain acceptable minute ventilation
- Low to moderate PEEP levels to avoid overdistension of “healthy” lung units
High respiratory rate that hampers patient-ventilator adaptation - Titrate drugs to control respiratory rate, e.g. opiates (morphine or fentanyl)§
Intense breathlessness reported by patients especially in the acute phase - Titrate drugs to control respiratory rate, e.g. opiates (morphine or fentanyl)§
- Rapid inspiratory curve
- Increase FIO2
  1. Footnotes: PEEP = positive end expiratory pressure; FIO2 = fraction of inspired oxygen
  2. § Matsumoto T, Tomii K, Tachikawa R, Otsuka K, Nagata K, Otsuka K, et al. Role of sedation for agitated patients undergoing noninvasive ventilation: clinical practice in a tertiary referral hospital. Bmc Pulm Med. 2015 Jul 13;15:71