Noninvasive ventilation (NIV) has been used for many years with great benefit in treating conditions such as chronic obstructive pulmonary disease (COPD) and cardiogenic pulmonary edema. These results have led to clinicians exploring the use of NIV outside of only chronic conditions and applying it to the acute and critical care setting. This alternative to traditional invasive ventilation in patients with respiratory compromise has garnered much interest in recent years. NIV potentially can provide the same therapeutic benefits of invasive ventilation while avoiding complications such as ventilator-associated pneumonia, prolonged intensive care unit (ICU) stays, and death. Data has begun to emerge showing the efficacy of NIV in patients with post-extubation respiratory failure, postoperative respiratory failure, and hypoxemic respiratory failure ranging from causes such as trauma to mild adult respiratory distress syndrome (ARDS). The currently available literature appears to show that NIV can be used to successfully treat these conditions while possibly improving outcomes when compared to traditional therapies. Despite these promising results, there is still a lack of high-quality evidence to support the routine use of NIV for every critical care application. As such, NIV should be viewed as a tool to be used in carefully selected patients who meet specific criteria but should not be seen as a replacement for invasive mechanical ventilation when it is clinically indicated. With this in mind, NIV can be an effective strategy when used in appropriate situations and should be considered a viable option for treating respiratory failure from a variety of causes.
KeywordsNoninvasive ventilation Respiratory failure Hypoxia Hypercapnia ARDS
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