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Know Your Ventilator to Beat the LeakKnow Your Ventilator

Dean R. Hess, PhD, RRT, FCCP; Richard D. Branson, MSc, RRT
Author and Funding Information

From the Harvard Medical School (Dr Hess), Massachusetts General Hospital (Dr Hess), and University of Cincinnati (Mr Branson).

Correspondence to: Dean R. Hess, PhD, RRT, FCCP, Respiratory Care, Ellison 401, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; e-mail: dhess@partners.org


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Hess has relationships with Philips Respironics; ResMed; Breathe Technologies, Inc; PARI Respiratory Equipment, Inc; and Covidien plc. Mr Branson has relationships with Covidien; General Electric Company; Ikaria, Inc; and Breathe Technologies, Inc. He has received honoraria for lecturing from Covidien and General Electric Company; serves as a technical consultant for Ikaria, Inc; and has received a grant to the University of Cincinnati from Breathe Technologies, Inc, and General Electric Company.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(2):274-275. doi:10.1378/chest.12-0489
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One of the significant advances in respiratory critical care over the past 20 years has been the emergence of noninvasive ventilation (NIV). Evidence supporting the use of NIV is strongest for COPD exacerbation and acute cardiogenic pulmonary edema. For these conditions, the use of NIV decreases the need for endotracheal intubation and affords a survival benefit.1

Although the use of NIV has increased, it remains underused.2-4 Moreover, a significant number of patients fail on NIV and go on to intubation.5 Factors that contribute to NIV failure include poor patient selection, progression of the underlying disease process, clinician inexperience, and lack of appropriate equipment.6 Several surveys have identified lack of appropriate equipment as an impediment to the implementation of NIV.3,4 Inappropriate equipment can refer to the choice of interface or the choice of ventilator.

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