How should I monitor a patient on NIV for potential complications or treatment failure?

Monitor the symptoms and signs listed in table 1 to detect potential respiratory impairment, including breathlessness, increased respiratory rate, orthopnoea, shallow breathing, recurrent chest infections, weak cough, disturbed sleep, use of accessory muscles, daytime sleepiness, reduced chest expansion, poor concentration, confusion, hallucinations, morning headaches, fatigue, poor appetite, and inward abdominal movement during inspiration ¹.

Assess respiratory function regularly, including measuring peak cough flow to evaluate cough strength ¹.

Observe for physiological signs such as increased respiratory rate, use of accessory muscles, and reduced chest expansion on maximal inspiration ¹.

Review sleep quality and patterns, noting non-refreshing sleep and nightmares ¹.

Evaluate neurobehavioural cues and overall wellbeing, including signs of fatigue and cognitive changes ².

Ensure ongoing clinical reviews to assess symptomatic and physiological changes, and adjust treatment accordingly ¹.