TNI Therapy

Notes on the TNI Therapy

The TNI therapy (therapy with nasal insufflation)is a non-invasive ventilation therapy for respiration support. Besides reducing pharyngeal collapsibility (Pcrit), TNI effectively increases PEEP, reduces respiratory effort and increases tracheal traction forces. In addition, reflex mechanisms in the hypopharynx are being discussed. During TNI treatment, a warm, humidified air flow is applied through the nose. Unlike CPAP, the TNI is an open system. On a pathophysiological basis, the TNI therapy is efficiently applied in the case of mild to moderate forms of sleep apnea and moderate COPD with and without sleep fragmenting snore events.

Application range of the TNI therapy:

1. Solves problems involved with mask therapy

2. Supports inhalative application of bronchodilationg sprays

3. During treatment of infections

4. O₂ humidification for large therapeutic quantities of O₂

5. Supports LTOT therapy

6. COPD after stabilized exacerbation

7. Fibrosis

8. OSA therapy

Prematures - Newborns - Infants - Children

9. Children with interface hypoplasia

10. Down´s syndrome

11. Bronchopulmonary dysplasia

12. Respiratory distress syndrome of the newborn

13. Postextubation

14. Bronchiolitis

1. Problemlöser für die Maskentherapie

• Mask phobia,
  • Feeling of anxiety under mask
  • Claustrophobia
  • Felling of shame, patient has problems with mask therapy
• Allergic incompatibility reaction
• Pressure sores
  • Bedsores
  • Open skin lesions

2. Supports inhalative application of bronchodilating sprays

• Complements, supports and optimizes medication efficiency
  • Prepares airways and lungs (PEEP)
  • Relieves respiratory pump
  • Delivers medication more directly to the target area
  • Reduces Rtot
  • Reduces RV/TLC

3. During treatment of infections

• Supports breathing,
  • Can prevent tracheostoma
  • Relieves respiratory pump
  • Improves oxygenation
  • Optimum humidification of O₂, even when O₂ > 3-6 L/min

4. O₂ humidification for large therapeutic quantities of O₂

• Optimum humidification of O₂
• Can be used with TNI 20s oxy without adding air
• Reduces mucous obstruction

5. Supports LTOT therapy

• Relieves respiratory pump
• Prevents nocturnal hypercapnia (replaces pursed lip breathing)
• Swirls the air/O₂ mixture in the dead air volume
  • Enriches the VD with "usable" air/O₂ mixture
• Increases thereby ventilation and CO₂ washout
• Improves respiratory efficiency
  • VD / VT and air ventilation of the lung (VA)
• Increases PEEP
  • Improves oxygenation
  • Replaces pursed lip breathing at night, improves CO₂ washout
  • Reduces Rtot
  • Reduces RV/TLC
• Reduces mucous obstruction

6. COPD after stabilized exacerbation

• Partially insufficient patients
  • With BGA trend for NIV therapy
• Globally insufficient patients
  • May replaces NIV completely
  • If NIC therapy is rejected
  • Replaces NIV therapy in the daytime
    • More patient comfort
    • More "freedom" (speaking, seeing)
• Relieves respiratory pump
• Swirls the air/O₂ mixture in the dead air volume
• Improves respiratory efficiency
  • VD / VT and air ventilation and CO₂ (VA)
  • Enriches the VD with "usable" air/O₂ mixture 
• Increases thereby ventilation and CO₂ washout
• Increases PEEP
  • Improves respiratory efficiency
  • Replaces pursed lip breathing at night, improves CO₂ washout
  • Reduces Rtot
  • Reduces RV/TLC
• Reduces mucous obstruction

7. Fibrosis

• Relieves respiratory pump
• Swirls the air/O₂ mixture in the dead air volume
  • Enriches the VD wirdh "usable" air/O₂ mixture
  • reduces VD
• improves respiratory efficiency
  • VD/VT
  • returns the patient´s state to the situation as it was about 3-6 Month ago
  • however, only temporarily, i. e. for the gained period of time

8. OSA Therapy

• Mild to moderate OSA
• UARS
• Relieves the respiratory pump
• Mask phobia,
  • Feeling of anxiety under mask
  • Claustrophobia
  • Feeling of shame, patient has problems with mask therapy
• Allergic incompatibility reaction
• Pressure sores
  • Bedsores
  • Open skin lesions

Prematures - Newborns - Infants - Children

9. Children with midface hypoplasia

• Mask intolerance by OSA therapy
• Necessary flow between 7-12 l/min
• Open System without a mask - high degree of wearing comfort - high degree of patient compliance

10. Down´s syndrome

• Mask intolerance by OSA therapy
  
• Necessary flow between 7-12 l/min
• Open System without a mask - high degree of wearing comfort - high degree of patient compliance

11. Bronchopulmonary dysplasia PD

• In order to support breathing after the extubation
• For temporal use during the first week of the newborn´s life
• Necessary flow between 5 - 9 L/min
• Mainly nightly use

12. Respiratory distress syndrome of the newborn

• For temporal use during the first weeks of the neubon´s life
• Necessary flow between 5 - 7 L/min
• Mainly nightly use

13. Postextubation

• In order to support breathing after the extubation
• Necessary flow between 5 - 7 L/min

14. Bronchiolitis

• In order to support breathing after the extubation
• Necessary flow between 5 - 7 L/min
• Open System without a mask - high degree of wearing comfort - high degree of patient compliance

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