In this section
Welcome to the North West Ventilation Service
We are a specialist respiratory team based at Wythenshawe Hospital, providing care and support to patients across the North West region. We care for patients with Hypercapnic respiratory failure who require a ventilator to help support their breathing at home. We have our own dedicated unit; the North West Ventilation Unit (NWVU).
Our multidisciplinary team assesses, treats and provides ongoing support for people who need help with their breathing. The treatment, known as ventilatory support, involves using a machine to assist breathing, often over the long term. This machine is called a ventilator.
What is hypercapnic failure?
Hypercapnic respiratory failure (also known as Type 2 respiratory failure) is a serious medical condition where the lungs cannot properly remove carbon dioxide from the blood, causing it to build up to dangerous levels. It is often referred to as ‘ventilatory failure’ because the lungs are not breathing effectively enough, either too shallowly or too slowly, to exhale the waste gas it produces. If left untreated you become very unwell. If you have type two respiratory failure, a ventilator might be recommended to help treat your condition.
A ventilator can help improve symptoms and enhance quality of life for people with a range of conditions. Our goal is to help individuals live as independently as possible at home.
We also have specialist expertise in managing respiratory and oral secretions, helping patients maintain airways and improve symptoms.
Conditions we treat
We support people with a range of conditions that affect breathing, including:
- Severe chest wall problems (such as kyphoscoliosis), where the shape of the chest makes it harder for the lungs to expand fully
- Long-term lung conditions (such as severe COPD), which can make breathing difficult and less effective
- Obesity hypoventilation syndrome, where breathing is too shallow or slow, often related to excess weight
- People with a tracheostomy, who may need additional support with breathing and airway care
- Neuromuscular conditions (such as motor neurone disease and muscular dystrophy), which can weaken the muscles needed for breathing
Our Team
Our team includes a range of healthcare professionals who work together to support your care. You may meet:
- Doctors, who oversee your treatment and medical care
- Nurses and physiotherapists, who provide day-to-day care and support with ventilation, education, and monitoring. They will assess your breathing and blood gases, setting you up on to a ventilator and training you and your carers on how to use this. The specialist team will provide support for patients across the region and work closely with community teams. We will provide specialist End of Life care if required. Physiotherapists can help if you have difficulty clearing phlegm off your chest, they may assess and provide you with a chest clearance programme.
- Occupational therapists, who support you with daily activities and independence at home
- Clinical physiologists, who carry out tests and help monitor your breathing and ventilatory support
- Speech and language therapists may assess and manage your eating and drinking to make sure food and drink is swallowed safely
- Dieticians will assess your nutritional intake and advise on dietary modifications, helping to ensure your nutritional needs are being met.
We aim to improve your quality of life by helping you to stay well for longer
What tests might I have?
To help us understand your condition and plan your care, we may carry out a range of tests, including:
- Oximetry and TOSCA monitoring are simple, non-invasive tests that measure the levels of oxygen and carbon dioxide in your blood by using sensors placed on your skin
- Breathing tests (lung function tests) measure how well your lungs are working
- Sleep studies assess your breathing overnight
- Capillary blood gas tests taken from your ear, check oxygen and carbon dioxide levels
- Cough strength tests assess how effectively you can clear your airways
- Swallowing assessments check if there are issues with food or drink being swallowed properly
- Blood tests check your overall health and how well your body is functioning
- X-rays and scans look at your lungs and chest
Possible treatment options
Non invasive ventilation (NIV)
A method of breathing support using a machine (a ventilator) that blows air into the lungs through a mask, this device is often used overnight.
A ventilator is a machine that helps to support your breathing by pushing air into and out of your lungs. By doing this it helps you take a deeper breath in and out, which allows more oxygen to pass into your lungs and body and helps remove carbon dioxide in the air you breathe out. The ventilator can be attached to your face through a mask covering your nose or mouth (non-invasive ventilation) or through a tracheostomy tube (invasive ventilation). This is the most common sort of breathing support.
Here are some of the ventilators we use in our service:
Tracheostomy
A small surgically created opening in the front of the neck leading directly into the windpipe (trachea) to help a person breathe. A small tube is placed into this hole to keep it open, allowing air to enter the lungs while bypassing the nose and mouth. It is used for long-term breathing support or to bypass airway obstructions. A ventilator can be attached to this tube to help with your breathing. Sometimes a tracheostomy might be in place for a few days or weeks or it could be in place for several months, years or life-long.
Cough assist
A device that helps people with weak muscles clear secretions from their lungs. It helps clear your lungs of phlegm. The machine works by pushing air into your lungs to help them fill with air and then quickly sucking the air out, clearing phlegm as it does so. It can be used with a face mask or via a tracheostomy tube.
LVR
A lung volume recruitment (LVR) bag is a small self-inflating handheld plastic bag, with a one-way valve attached to it. It is used with either a face mask or a mouthpiece. As you take a breath in, the bag is squeezed at the same time, allowing you to ‘breath stack’. By taking a bigger breath in, you have more air to help improve the strength of your cough.
Percutaneous Endoscopic Gastrostomy (PEG)
A Percutaneous Endoscopic Gastrostomy (PEG) is a feeding tube inserted directly into the stomach through a small incision in the abdomen that allows long-term nutrition, fluids and medications when a person cannot swallow safely or eat enough by mouth.
Research
We are committed to continually improving our service and regularly take part in audits, research, and quality improvement projects to ensure we provide the best possible care.
Referral information
Referrals can be made to NWVS for the following services
- NIV
- Cough assist
- Botulinum toxin to treat sialorrhoea
For an NIV referral form please email/phone contact details for referrers
Referral forms will be sent as requested, please email or call the contacts details below
- Helpline 0161 291 6357
- NWVUadmin@mft.nhs.uk
Consultants
- Dr Andras Bikov - Consultant in Respiratory Medicine
- Dr Maria del Carmen Mascareno Ponte - Respiratory Consultant