Noninvasive Positive-Pressure Ventilation for Acute Respiratory Failure: Comparative Effectiveness
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.
- Williams JW Jr, Cox CE, Hargett CW, et al. Noninvasive Positive-Pressure Ventilation (NPPV) for Acute Respiratory Failure: Comparative Effectiveness. Comparative Effectiveness Review No. 68 (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I). Rockville, MD: Agency for Healthcare Research and Quality; July 2012. AHRQ Publication No. 12-EHC089-EF. Available at www.effectivehealthcare.ahrq.gov/nppv.cfm.
- Pierson DJ. History and epidemiology of noninvasive ventilation in the acute-care setting. Respir Care 2009;54(1):40-52. PMID: 19111105.
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