Pre-course: Non-invasive Ventilations

Saturday 10 October: 9:00 - 17:00


Course Director

  • Roberto Cosentini (Italy)
  • Paolo Groff (Italy)


  • Anna Maria Brambilla (Italy)
  • Abdo Khoury (France)
  • Roberta Petrino (Italy)

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


09:00 How I treat hypoxemic patients:
Acute Cardiogenic Pulmonary Edema (ACPE):
■ clinical cases
■ pathophysiology & literature
■ How I use CPAP
■ clinical cases
■ pathophysiology & literature
10:45 Coffee break
■ CPAP hands-on.
12:00 Lunch break.
13:00 How I treat hypercapnic patients:
COPD exacerbation:
■ clinical cases
■ pathophysiology & literature
■ ventilation modalities and patient-ventilator interaction
14:45 Coffee break
■ NIV hands-on
17:00 End of course


  1. 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
  2. Ferrer M, Torres A. Noninvasive ventilation for acute respiratory failure. Curr Opin Crit Care. 2015 Feb;21(1):1-6