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Noninvasive Positive-Pressure Ventilation for Acute Respiratory Failure: Comparative Effectiveness

Slide: 6 of 25

Noninvasive Positive-Pressure Ventilation for Managing Acute Respiratory Failure (2 of 3)

The use of NPPV together with supportive care during the treatment of respiratory failure is attractive because:

  • It does not require either endotracheal intubation or moderate and/or deep sedation.
  • It can be safely initiated or discontinued as needed.
  • It is associated with few of the nosocomial complications that are associated with endotracheal intubation, such as ventilator-associated pneumonia, critical illness-associated weakness, pneumothorax, delirium, and infections associated with the invasive monitoring that is typically required during invasive life support.

NPPV is contraindicated in some patients, including those with cardiopulmonary arrest or shock (where greater airway control is required), those with facial trauma (where the interface [e.g., mask] cannot be used appropriately), those with severely impaired consciousness, those with high aspiration risk, and those who are unable to cooperate, protect the airway, or clear secretions.