ABSTRACT
Non-invasive ventilation Non-invasive positive-pressure ventilation (NIPPV) is a method of respiratory support that can be provided by standard ventilators via a facemask. Most clinical practice with NIPPV is in managing chronic stable respiratory failure, but experience is growing in its use in the management of acute disease. NIPPV is gaining a place as a therapeutic option for patients who would otherwise be intubated. The indications for NIPPV are: 1. It avoids intubation in acute hypercapnic respiratory failure. 2. It circumvents the need for tracheotomy in patients recovering from criti-
cal illness or surgery. 3. It improves the preoperative cardiorespiratory function in patients with
chronic ventilatory failure. 4. It facilitates weaning from mechanical ventilation. 5. It acts as a ‘bridge’ to transplantation in patients with end-stage respiratory
failure. The use of NIPPV has been described in:
• chronic obstructive pulmonary disease (COPD) • chest wall disorders • pneumonia • cardiac failure • cystic fibrosis • obstructive sleep apnoea • asthma • postoperative ventilatory support.
