Eusem - Pre-course: Non-invasive Ventilation

Saturday 1 October: 9:00 - 17:00

Course Director

Roberto Cosentini (Italy)

Faculty

Abdo Khoury (France)
Rodolpho Ferrari (Italy)
Roberta Marino (Italy)
Patrick Plaisance (France)

The dyspnoea epidemic

Acute dyspnoea is one of the most common emergencies in the ED, accounting for 3-5% of all admissions. The vast majority of cases are represented by acute heart failure, pneumonia and COPD exacerbation.

Why Non Invasive Positive Pressure Ventilation is relevant to ED doctors

One of the major advances in acute respiratory failure treatment is Non Invasive Positive Pressure Ventilation (NPPV). The application of non-invasive positive pressure has been proved superior to standard treatment and should belong to the therapeutic armamentarium of the emergency physician. According to the literature, the application of NPPV in the treatment of acute cariogenic pulmonary edema (ACPE) allows to avoid 1 endotracheal intubation (ETI) out of 8 patients (NNT = 8) and 1 death every 13 treated patients (NNT = 13) in comparison to standard treatment. For patients with severe COPD exacerbation, NIV has an even better NNT of 5 for ETI, and 8 for mortality. Just to have an idea, aspirin and lytics in AMI have a NNT for mortality of 42 and 43, respectively.

NIV has also proved useful for pneumonia in the immunompromised population and recent data suggest could be useful also as an early approach in pneumonia in the immunocompetent patients.

How the course runs

This is highly interactive course with a predominant part of training sessions on ventilatory stations. The course will bring you cutting edge information on Non Invasive Positive Pressure Ventilation use and caveats, with a focus on most common cases. For each indication, a hands on session will be run on a different ventilator and CPAP device stations with cognitive simulation of clinical scenarios.

At the end of the course, the participant will be able to:

evaluate the correct indications for NPPV
set both the ventilators and CPAP devices
critically analyze ventilator/patient interactions
evaluate intolerance and devise corrections

Schedule

09:00	How I treat hypoxemic patients:
	Acute Cardiogenic Pulmonary Edema (ACPE): Roberto Consentini ■ clinical cases ■ pathophysiology & literature ■ How I use CPAP
10:00	Pneumonia: Roberta Marino ■ clinical cases ■ pathophysiology & literature
10:45	Coffee break
11:00	■ The Earlier the Better? NIMV in the pre-hospital Setting. Patrick Plaisance
11:30	■ CPAP hands-on.
12:30	Lunch break
13:00	How I treat hypercapnic patients:
	COPD exacerbation: Abdo Khoury ■ clinical cases ■ pathophysiology & literature
13:45	■ Ventilators & Ventilation. Roberto Ferrari
14:45	Coffee break
15:00	■ NIV hands-on
17:00	End of course

References

Cabrini L, Landoni G, Oriani A, Plumari VP, Nobile L, Greco M, Pasin L, Beretta L, Zangrillo A. Noninvasive ventilation and survival in acute care settings: a comprehensive systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2015 Apr;43(4):880-8
Ferrer M, Torres A. Noninvasive ventilation for acute respiratory failure. Curr Opin Crit Care. 2015 Feb;21(1):1-6
www.thennt.com