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.
