ICU · Advanced respiratory support

Advanced Respiratory Support — NIV, Weaning and Tracheostomy

Also known as Non-invasive ventilation · CPAP · BiPAP · Weaning · Spontaneous breathing trial · Tracheostomy · Extubation · Respiratory muscle fatigue

Advanced respiratory support covers the three skills that frame the respiratory failure beyond the ventilator — the non-invasive ventilation (the CPAP and the BiPAP, their indications and their evidence), the liberation from the mechanical ventilation (the spontaneous breathing trial, the weaning protocol, the difficult-to-wean patient and the role of the NIV-facilitated extubation), and the tracheostomy (the timing, the technique, the decannulation). This topic builds the examiner's framework on the NIV physiology (the positive pressure that unloads the respiratory muscles, the CPAP for the oxygenation, the BiPAP for the ventilation), the weaning evidence (the Esteban comparison of the four methods, the role of the NIV in the post-extubation failure, the Burns review of the NIV-assisted weaning), and the tracheostomy timing question.

Checked against its sources on 14 Oct 2026