Place and modalities of sedation during non-invasive ventilation

Abstract

One major key of success of non-invasive ventilation (NIV) is the patient’s comfort. Despite the optimization of interfaces, settings, and ventilatory parameters, some patients have to be intubated because of low NIV tolerance. Adapted sedation can overcome this difficulty, aiming to reduce intubation incidence. Even if the use of sedative agents is frequently reported in the literature, only a few prospective studies have tested sedation protocols adapted to this situation. Administration of drugs with rapid onset and short duration of action, using target-controlled infusion should avoid NIV failure due to patient’s intolerance. Sedation objective is not to delay intubation but rather to allow NIV continuation in case of intolerance or major discomfort.