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Noninvasive ventilation in acute respiratory failure in adults

Author
Robert C Hyzy, MD
Section Editor
Polly E Parsons, MD
Deputy Editor
Geraldine Finlay, MD

INTRODUCTION

Noninvasive ventilation (NIV) refers to positive pressure ventilation delivered through a noninvasive interface (nasal mask, facemask, or nasal plugs), rather than an invasive interface (endotracheal tube, tracheostomy). Its use has become more common as its benefits are increasingly recognized [1,2]. (See "Overview of mechanical ventilation", section on 'Types of breaths'.)

The use of NIV for acute respiratory failure is discussed here, including its indications, contraindications, benefits, and potential harms. Initiation and weaning of NIV are also reviewed. NIV for neuromuscular disorders, chest wall disease, or obesity hypoventilation syndrome is described separately. (See "Noninvasive positive pressure therapy of the obesity hypoventilation syndrome" and "Types of noninvasive nocturnal ventilatory support in neuromuscular and chest wall disease" and "Continuous noninvasive ventilatory support for patients with neuromuscular or chest wall disease".)

PATIENT SELECTION

Selecting patients for NIV requires careful consideration of its indications and contraindications, which are discussed in this section.

Indications — A trial of NIV is worthwhile in most patients who do not require emergent intubation and have a disease known to respond to NIV, assuming that they lack contraindications [3]. This is especially true for patients who have features that predict success using NIV (table 1).

Conditions known to respond to NIV include (see 'Benefits' below):

                     

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 21 00:00:00 GMT 2016.
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