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- A recent meta-analysis found that non-invasive ventilation can improve survival in acute care settings.
- Consider using NIPPV in:
- COPD exacerbation
- Obesity hypoventilation syndrome
- Asthma
- Hypoxemic respiratory failure
- Cardiogenic pulmonary edema
- ARDS
- Make sure to reassess your patients for improvement within one hour of applying NIPPV. If gas exchange has not significantly improved then endotracheal intubation and mechanical ventilation should be considered.
- Adverse effects:
- Gastric distension
- Pressure ulcers on the face
- Can be uncomfortable
- In cardiogenic pulmonary edema there are cardiac performance benefits:
- Decreases preload
- Decreases left ventricular afterload
- Improved cardiac ouput
References
Cabrini L et al. Noninvasive ventilation and survival in acute care settings: a comprehensive systematic review and metaanalysis of randomized controlled trials. Crit Care Med 2015; 43:880-888.