Non-invasive BiPAP--implementation of a new service.

Non-invasive ventilation has been shown to be an effective treatment for acute hypercapnic respiratory failure. It is now increasingly used in the treatment of acute hypoxemic respiratory failure. National guidelines published by the British Thoracic Society state that facilities for NIV should be available 24 hours per day in all hospitals likely to admit such patients. If an acute NIV service is not provided, the shortage of Intensive Care beds means that some patients will die because facilities to invasively ventilate are not available. Conversely, results of a survey performed by the indicate that at the time of data collection, only 48% of United Kingdom hospitals provided an acute NIV service. The BiPAP Vision (Respironics Inc.) offers Continuous Positive Airway Pressure (CPAP), Bi-level Spontaneous/Timed and Proportional Assist Ventilation/Timed modes and is ideal for use in a critical care environment. This article presents some of the issues surrounding NIV, the impact of a new service, and the process of implementing NIV within a critical care setting.