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The non-invasive ventilation protocol in use at the University Lewisham Hospital London

Anouka Rua De Silva1, Andreea C. Herescu2, Tudor P. Toma1
The non-invasive ventilation protocol in use at the University Lewisham Hospital London



The term non-invasive ventilation (NIV) includes both continuous positive pressure ventilation (CPAP) and non-invasive (bi-level) positive pressure ventilation (NIPPV). The introduction of NIV in clinical practice improved significantly the outcomes in patients with respiratory failure. The fact that NIV machines are simple to use, do not require endotracheal intubation, and can save lives, has led to their increased use by non ITU personnel. However, for an efficient use of NIV it is very important that the patients are treated according to strict local protocols. In order to support the writing of local NIV protocols in Romania, we present here the NIV protocol in use at the University Lewisham Hospital, London, United Kingdom.


Keywords: non-invasive ventilation, continuous positive pressure ventilation, non-invasive (bi-level) positive pressure ventilation, respiratory failure, hypoxemia, hypercapnia.


Contact: Tudor P. Toma, Department of Respiratory Medicine, University Hospital Lewisham, London, UK. Lewisham High Street, London, SE13 6LH. Email:


Update in bronchoscopic techniques

Marioara Simon1, Ioan Simon2
Update in bronchoscopic techniques


Bronchoscopy is a central technique in diagnosing lung cancer, but also in different therapeutic approache. The most common indication for bronchoscopy is for tissue sampling and determining the extent of lung cancer. Established diagnostic techniques are forceps biopsy, aspiration or brush cytology sampling, or needle aspiration. Laser therapy, electrocautery, cryotherapy and stenting are well-described techniques for the palliation of symptoms due to airway involvement in patients with advanced stages. Newer technologies, with an established role in clinical practice, are endobronchial ultrasound, autofluorescence bronchoscopy, and electromagnetic navigation. Other technologies, such as magnification, narrow-band imaging and confocal fluorescence microendoscopy, are in development for the use within the airways.

Key words: fibrobronchoscopy, techniques, bronchopulmonary neoplasm.


Contact: Marioara Simon,