open access

Vol 87, No 1 (2019)
REVIEWS
Published online: 2019-03-04
Submitted: 2018-12-12
Accepted: 2019-02-05
Get Citation

Noninvasive ventilation: education and training. A narrative analysis and an international consensus document

Habib Mohammad Reazaul Karim, Karen E A Burns, Laura D Ciobanu, Mohamad El-Khatib, Antonello Nicolini, Nicola Vargas, Thierry Hernández-Gilsoul, Szymon Skoczyński, Vito Antonio Falcone, Jean-Michel Arnal, John Bach, Luca Salvatore De Santo, Alberto Lucchini, Joerg Steier, Andrea Purro, Angelo Petroianni, Catherine S Sassoon, Stefano Bambi, Margarida Aguiar, Ayman O Soubani, Corinne Taniguchi, Corrado Mollica, David A Berlin, Edoardo Piervincenzi, Fabrizio Rao, Ferini-Strambi Luigi, Rodolfo Ferrari, Giancarlo Garuti, Gerhard Laier-Groeneveld, Giuseppe Fiorentino, Kwok M Ho, Jaber Saud Alqahtani, Manuel Luján, Onnen Moerer, Onofrio Resta, Paola Pierucci, Peter Papadakos, Stephan Steiner, Sven Stieglitz, Yalim Dikmen, Jun Duan, Pradipta Bhakta, Alejandro Ubeda Iglesias, Nadia Corcione, Vânia Caldeira, Zuhal Karakurt, Gabriele Valli, Eumorfia Kondili, Maria Pia Ruggieri, Margarida Simões Raposo, Fabrizio Bottino, Rafael Soler-González, Mohan Gurjar, José Luis Sandoval-Gutierrez, Behrouz Jafari, Marta Arroyo-Cozar, Ana Roca Noval, Nadia Corcione, Igor Barjaktarevic, Irena Sarc, Bushra Mina, Zbigniew Szkulmowski, Corinne Taniguchi, Antonio M. Esquinas
DOI: 10.5603/ARM.a2019.0006
·
Pubmed: 30830962
·
Adv Respir Med 2019;87(1):36-45.

open access

Vol 87, No 1 (2019)
REVIEWS
Published online: 2019-03-04
Submitted: 2018-12-12
Accepted: 2019-02-05

Abstract

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time
and if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of its
proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training.
Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews
with the results analyzed by a team of experts across the world through e-mail based communications.
Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with
indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented
only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV
education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated.
Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using
NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing
countries.

Abstract

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time
and if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of its
proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training.
Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews
with the results analyzed by a team of experts across the world through e-mail based communications.
Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with
indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented
only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV
education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated.
Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using
NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing
countries.

Get Citation

Keywords

noninvasive ventilation, training, education, programs, staff

About this article
Title

Noninvasive ventilation: education and training. A narrative analysis and an international consensus document

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 1 (2019)

Pages

36-45

Published online

2019-03-04

DOI

10.5603/ARM.a2019.0006

Pubmed

30830962

Bibliographic record

Adv Respir Med 2019;87(1):36-45.

Keywords

noninvasive ventilation
training
education
programs
staff

Authors

Habib Mohammad Reazaul Karim
Karen E A Burns
Laura D Ciobanu
Mohamad El-Khatib
Antonello Nicolini
Nicola Vargas
Thierry Hernández-Gilsoul
Szymon Skoczyński
Vito Antonio Falcone
Jean-Michel Arnal
John Bach
Luca Salvatore De Santo
Alberto Lucchini
Joerg Steier
Andrea Purro
Angelo Petroianni
Catherine S Sassoon
Stefano Bambi
Margarida Aguiar
Ayman O Soubani
Corinne Taniguchi
Corrado Mollica
David A Berlin
Edoardo Piervincenzi
Fabrizio Rao
Ferini-Strambi Luigi
Rodolfo Ferrari
Giancarlo Garuti
Gerhard Laier-Groeneveld
Giuseppe Fiorentino
Kwok M Ho
Jaber Saud Alqahtani
Manuel Luján
Onnen Moerer
Onofrio Resta
Paola Pierucci
Peter Papadakos
Stephan Steiner
Sven Stieglitz
Yalim Dikmen
Jun Duan
Pradipta Bhakta
Alejandro Ubeda Iglesias
Nadia Corcione
Vânia Caldeira
Zuhal Karakurt
Gabriele Valli
Eumorfia Kondili
Maria Pia Ruggieri
Margarida Simões Raposo
Fabrizio Bottino
Rafael Soler-González
Mohan Gurjar
José Luis Sandoval-Gutierrez
Behrouz Jafari
Marta Arroyo-Cozar
Ana Roca Noval
Nadia Corcione
Igor Barjaktarevic
Irena Sarc
Bushra Mina
Zbigniew Szkulmowski
Corinne Taniguchi
Antonio M. Esquinas

References (57)
  1. Esquinas R, Martín UJ, Cordova FC, Criner GJ, González Dí. Organizaciónhospitalaria y formaciónclínicaenventilaciónmecánica no invasiva. In: Esquinas R. ed. Tratado de ventilaciónmecánica no invasiva. Prácticaclínica y metodología. Aula Medica, Madrid 2006: 1129–1134.
  2. Simonds AK. Non-invasive respiratory support. A practical handbook. 2nd Ed. Arnold, London 2001: 230–45.
  3. Haniffa R, Lubell Y, Cooper BS, et al. ICU Training in South Asia Group. Impact of a structured ICU training programme in resource-limited settings in Asia. PLoS One. 2017; 12(3): e0173483.
  4. Sullivan AM, Rock LK, Gadmer NM, et al. The Impact of Resident Training on Communication with Families in the Intensive Care Unit. Resident and Family Outcomes. Ann Am Thorac Soc. 2016; 13(4): 512–521.
  5. Gaba DM. The future vision of simulation in healthcare. Simul Healthc. 2007; 2(2): 126–135.
  6. Ziv A, Ben-David S, Ziv M. Simulation based medical education: an opportunity to learn from errors. Med Teach. 2005; 27(3): 193–199.
  7. McGaghie WC, Issenberg SB, Petrusa ER, et al. Effect of practice on standardised learning outcomes in simulation-based medical education. Med Educ. 2006; 40(8): 792–797.
  8. Cook DA, Hatala R, Brydges R, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011; 306(9): 978–988.
  9. McGaghie WC, Issenberg SB, Cohen ER, et al. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011; 86(6): 706–711.
  10. Chatwin M, Hare A, Kurosinski P, et al. Evaluation of the educational outcomes of simulation-based training (SBT) for NIV. 2.2 Noninvasive Ventilatory Support. 2015.
  11. Colt HG, Crawford SW, Galbraith O. Virtual reality bronchoscopy simulation: a revolution in procedural training. Chest. 2001; 120(4): 1333–1339.
  12. Spadaro S, Karbing DS, Fogagnolo A, et al. Simulation Training for Residents Focused on Mechanical Ventilation: A Randomized Trial Using Mannequin-Based Versus Computer-Based Simulation. Simul Healthc. 2017; 12(6): 349–355.
  13. Confalonieri M, Garuti G, Cattaruzza MS, et al. Italian noninvasive positive pressure ventilation (NPPV) study group. A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation. Eur Respir J. 2005; 25(2): 348–355.
  14. Bhattacharyya D, Prasad B, Tampi PS, et al. Early predictors of success of non-invasive positive pressure ventilation in hypercapnic respiratory failure. Med J Armed Forces India. 2011; 67(4): 315–319.
  15. Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017; 50(2).
  16. Lopez-Campos JL, Garcia Polo C, Leon Jimenez A, et al. Staff training influence on non-invasive ventilation outcome for acute hypercapnic respiratory failure. Monaldi Arch Chest Dis. 2006; 65(3): 145–151.
  17. Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000; 355(9219): 1931–1935.
  18. Roberts CM, Stone RA, Buckingham RJ, et al. National Chronic Obstructive Pulmonary Disease Resources and Outcomes Project implementation group. Acidosis, non-invasive ventilation and mortality in hospitalised COPD exacerbations. Thorax. 2011; 66(1): 43–48.
  19. Ozyilmaz E, Ugurlu AO, Nava S. Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies. BMC Pulm Med. 2014; 14: 19.
  20. Dretzke J, Blissett D, Dave C, et al. The cost-effectiveness of domiciliary non-invasive ventilation in patients with end-stage chronic obstructive pulmonary disease: a systematic review and economic evaluation. Health Technol Assess. 2015; 19(81): 1–246.
  21. Nicolini A, Stieglitz S, Bou-Khalil P, et al. Cost-utility of non-invasive mechanical ventilation: Analysis and implications in acute respiratory failure. A brief narrative review. Respir Investig. 2018; 56(3): 207–213.
  22. Patel SP, Pena ME, Babcock CI. Cost-effectiveness of noninvasive ventilation for chronic obstructive pulmonary disease-related respiratory failure in Indian hospitals without ICU facilities. Lung India. 2015; 32(6): 549–556.
  23. Kramer N, Meyer TJ, Meharg J, et al. Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med. 1995; 151(6): 1799–1806.
  24. Maheshwari V, Paioli D, Rothaar R, et al. Utilization of noninvasive ventilation in acute care hospitals: a regional survey. Chest. 2006; 129(5): 1226–1233.
  25. Plumb JOM, Juszczyszyn M, Mabeza G. Non-Invasive Ventilation (NIV) a Study of Junior Doctor Competence~!2010-3-17~!2010-05-15~!2010-06-30~! The Open Medical Education Journal. 2010; 3(1): 11–17.
  26. Vanpee D, Delaunois L, Lheureux P, et al. Survey of non-invasive ventilation for acute exacerbation of chronic obstructive pulmonary disease patients in emergency departments in Belgium. Eur J Emerg Med. 2002; 9(3): 217–224.
  27. Di Marco F, Centanni S, Bellone A, et al. Optimization of ventilator setting by flow and pressure waveforms analysis during noninvasive ventilation for acute exacerbations of COPD: a multicentric randomized controlled trial. Crit Care. 2011; 15(6): R283.
  28. Hess DR. How to initiate a noninvasive ventilation program: bringing the evidence to the bedside. Respir Care. 2009; 54: 232–243.
  29. Rose L, Gray S, Burns K, et al. Management of critically ill patients receiving noninvasive and invasive mechanical ventilation in the emergency department. Open Access Emerg Med. 2012; 4: 5–15.
  30. Cox CE, Carson SS, Ely EW, et al. Effectiveness of medical resident education in mechanical ventilation. Am J Respir Crit Care Med. 2003; 167(1): 32–38.
  31. Nápolis LM, Jeronimo LM, Baldini DV, et al. Availability and use of noninvasive ventilation in the intensive care units of public, private and teaching hospitals in the greater metropolitan area of São Paulo, Brazil. J Bras Pneumol. 2006; 32(1): 29–34.
  32. Bierer GB, Soo Hoo GW. Noninvasive ventilation for acute respiratory failure: a national survey of Veterans Affairs hospitals. Respir Care. 2009; 54(10): 1313–1320.
  33. Davies JD, Gentile MA. What does it take to have a successful noninvasive ventilation program? Respir Care. 2009; 54(1): 53–61.
  34. Tallo FS, de Campos Vieira Abib S, de Andrade Negri AJ, et al. Evaluation of self-perception of mechanical ventilation knowledge among Brazilian final-year medical students, residents and emergency physicians. Clinics (Sao Paulo). 2017; 72(2): 65–70.
  35. Simonelli C, Paneroni M, Vitacca M. An implementation protocol for noninvasive ventilation prescription: the physiotherapist's role in an Italian hospital. Respir Care. 2013; 58(4): 662–668.
  36. Scala R, Windisch W, Köhnlein T, et al. European Respiratory Society Respiratory Intensive Care Assembly. Targeting European Respiratory Society Group activities: a survey of the Noninvasive Ventilatory Support Group. Eur Respir Rev. 2014; 23(132): 258–260.
  37. Miller S, Latham M, Elliott MW. Where to perform NIV. Noninvasive Ventilation. 2008: 189–199.
  38. Bach JR, Chiou M. Limitations of evidence-based medicine. Rev Port Pneumol (2006). 2016; 22(1): 4–5.
  39. McQueen S, Dickinson M, Pimblett M. Human patient simulation can aid staff training in non-invasive ventilation. Nurs Times. 2010; 106(26): 20.
  40. Schönhofer B, Hart N, Scala R, et al. ERS noninvasive ventilation course: basic concepts. Breathe (Sheff). 2017; 13(2): 81–83.
  41. Advanced noninvasive ventilation course: the participants' view. Breathe (Sheff). 2016; 12(2): e20–e21.
  42. Mitchell S, Bloch KE, Butiene I, et al. "Education is the passport to the future": enabling today's medical teachers to prepare tomorrow's respiratory health practitioners. Eur Respir J. 2014; 44(3): 578–584.
  43. Artigas A, Noël JL, Brochard L, et al. Defining a training framework for clinicians in respiratory critical care. Eur Respir J. 2014; 44(3): 572–577.
  44. Chawla R, Sidhu US, Kumar V, et al. Noninvasive ventilation: a survey of practice patterns of its use in India. Indian J Crit Care Med. 2008; 12(4): 163–169.
  45. British Thoracic Society Standards of Care Committee. Non-invasive ventilation in acute respiratory failure. Thorax. 2002; 57(3): 192–211.
  46. Davies M, Allen M, Bentley A, et al. British Thoracic Society Quality Standards for acute non-invasive ventilation in adults. BMJ Open Respir Res. 2018; 5(1): e000283.
  47. Burns KEA, Sinuff T, Adhikari NKJ, et al. Bilevel noninvasive positive pressure ventilation for acute respiratory failure: survey of Ontario practice. Crit Care Med. 2005; 33(7): 1477–1483.
  48. Chawla R, Khilnani GC, Suri JC, et al. Indian Society of Critical Care Medicine. Guidelines for noninvasive ventilation in acute respiratory failure. Indian J Crit Care Med . 2006; 10(117): 147.
  49. Ozsancak Ugurlu A, Sidhom SS, Khodabandeh A, et al. Where should noninvasive ventilation be delivered? Respir Care. 2009; 54(1): 62–70.
  50. Hare A, Simonds A. Simulation-based education for non-invasive ventilation. Breathe. 2013; 9(5): 366–374.
  51. Nayahangan LJ, Clementsen PF, Paltved C, et al. Identifying Technical Procedures in Pulmonary Medicine That Should Be Integrated in a Simulation-Based Curriculum: A National General Needs Assessment. Respiration. 2016; 91(6): 517–522.
  52. Brill AK, Moghal M, Morrell MJ, et al. Randomized crossover trial of a pressure sensing visual feedback system to improve mask fitting in noninvasive ventilation. Respirology. 2017; 22(7): 1343–1349.
  53. Longhini F, Colombo D, Pisani L, et al. Efficacy of ventilator waveform observation for detection of patient-ventilator asynchrony during NIV: a multicentre study. ERJ Open Res. 2017; 3(4).
  54. Ergan B, Nasiłowski J, Winck JC. How should we monitor patients with acute respiratory failure treated with noninvasive ventilation? Eur Respir Rev. 2018; 27(148).
  55. Willson GN, Piper AJ, Norman M, et al. Nasal versus full face mask for noninvasive ventilation in chronic respiratory failure. Eur Respir J. 2004; 23(4): 605–609.
  56. Storre JH, Huttmann SE, Ekkernkamp E, et al. Oxygen supplementation in noninvasive home mechanical ventilation: the crucial roles of CO2 exhalation systems and leakages. Respir Care. 2014; 59(1): 113–120.
  57. Davidson AC, Banham S, Elliott M, et al. BTS Standards of Care Committee Member, British Thoracic Society/Intensive Care Society Acute Hypercapnic Respiratory Failure Guideline Development Group, On behalf of the British Thoracic Society Standards of Care Committee. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults. Thorax. 2016; 71 Suppl 2: ii1–i35.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl