Practical Device Setup, Titration and Monitoring

Prof. Cesare Gregoretti
Head of Anesthesiology and Intensive Care Unit, Fondazione Istituto G. Giglio, Cefalù, Italy
University of Palermo, Italy

How to Set Up a Home NIV Device: Interfaces, Ventilation Modes and Practical Titration

Topics:

  • Home NIV ventilator platforms
  • Choosing the right interface: nasal masks, oronasal masks, under-the-nose masks, total face masks
  • Circuit configuration
  • Ventilation modes: S mode, ST mode, T mode, AVAPS / iVAPS / VAPS
  • Essential settings: IPAP, EPAP, backup respiratory rate, inspiratory time, rise time, cycling sensitivity
  • Low-intensity versus high-intensity NIV
  • Practical demonstration: initial setup, optimization, leak management, trigger and synchrony adjustment

Key message: „Successful NIV depends more on proper setup than on the ventilator itself.”

Dimitrios Nasys
NIV Clinical Specialist, ResMed

Home NIV in Neuromuscular Diseases and Kyphoscoliosis: Initial Settings and Personalized Ventilation Strategies

Topics:

  • Restrictive physiology and chronic hypoventilation
  • Early signs of nocturnal hypoventilation
  • Role of FVC, SNIP and MIP
  • Practical titration strategies: ABG-guided titration, SpO2/TcCO2-guided titration
  • NIV in ALS, muscular dystrophies, SMA and severe kyphoscoliosis
  • Initial NIV settings in restrictive disorders
  • Titration strategies for neuromuscular disease
  • Target tidal volume optimization
  • Backup respiratory rate optimization
  • Secretion management
  • Transition to daytime ventilation

Key message: „In neuromuscular disease, individualized titration and timing of NIV initiation are critical.”

Assoc. Prof. Oana Deleanu, MD, PhD
President of the Romanian Section of Sleep Medicine and Non-Invasive Ventilation
Bucharest, Romania

Home NIV in COPD and Obesity Hypoventilation Syndrome: High-Intensity NIV, Monitoring and Troubleshooting

Topics:

  • Which COPD patients truly benefit from Home NIV?
  • Chronic hypercapnic COPD
  • High-intensity NIV in COPD
  • NIV in overlap syndrome
  • Obesity hypoventilation syndrome: when CPAP is sufficient and when NIV is required
  • Initial NIV settings in COPD and OHS
  • Common problems: leaks, patient-ventilator asynchrony, intolerance, aerophagia, dryness
  • Telemonitoring and follow-up
  • Download interpretation: compliance, leaks, residual respiratory events, minute ventilation
  • When and how to adjust settings

Key message: „Continuous monitoring and optimization are essential for effective long-term Home NIV.”

Live Practical Session

Hands-On NIV Device Setup and Optimization

  • Mask fitting
  • Interface selection
  • Circuit setup
  • Initial parameter configuration
  • Leak interpretation
  • Trigger sensitivity adjustment
  • Synchrony optimization
  • Download analysis
  • Troubleshooting real-life cases