Synonym: noninvasive ventilation (NIV)
Advantages of NPPV when it works:
(1) avoids intubation
(2) avoids complications of mechanical ventilation
(3) reduces admissions to the intensive care unit (ICU)
(4) shortens the hospital stay
(5) reduces costs
Patient selection:
(1) hypoxemia (PaO2 < 60 mm Hg)
(2) arterial pH>= 7.25
(3) hemodynamically stable
(4) absence of acute myocardial infarction or cardiac arrest
A patient responding to NPPV will show within a few hours:
(1) an increase in arterial pH (often the first sign of improvement)
(2) a decrease in arterial PaCO2
(3) an increased PaO2
(4) a decrease in the respiratory rate
(5) decreased breathlessness
Closer monitoring may be needed for a patient with risk factors for deterioration:
(1) advanced COPD
(2) older age
(3) hypotension
(4) renal or other organ failure
