Noninvasive ventilation decreased endotracheal intubation rates and hospital mortality in acute hypoxemia non-hypercapnic respiratory failure excluding chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema patients. There is no sufficient scientific evidence to recommend bi-level positive airway pressure or helmet due to the limited number of trials available. Large rigorous randomized trials are needed to answer these questions definitely.
Who Needs It?
- Patients with moderate to severe COPD exacerbations
- Those patients with cardiogenic pulmonary edema with increased work of breathing or hypercapnia
- Patients with isolated blunt thoracic trauma
- The immunocompromised patient with hypoxic respiratory failure
- Patients who require pre-oxygenation prior to intubation