ABSTRACT
Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. The literature for other respiratory pathologies where NIV may be used, such as in asthma exacerbation, pediatric patients, and community-acquired pneumonia, is also reviewed. Controversies and potential future applications of NIV are presented. [Points & Pearls is a digest of Emergency Medicine Practice].
Subject(s)
Noninvasive Ventilation/methods , Respiratory Distress Syndrome/therapy , Asthma/therapy , Community-Acquired Infections/therapy , Continuous Positive Airway Pressure/methods , Continuous Positive Airway Pressure/trends , Drowning , Humans , Lung Diseases, Interstitial/therapy , Noninvasive Ventilation/adverse effects , Noninvasive Ventilation/instrumentation , Positive-Pressure Respiration/methods , Positive-Pressure Respiration/trends , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Edema/therapyABSTRACT
Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Characteristics of patients who are most likely to benefit from NIV are reviewed, including those in respiratory distress from chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. The literature for other respiratory pathologies where NIV may be used, such as in asthma exacerbation, pediatric patients, and community-acquired pneumonia, is also reviewed. Controversies and potential future applications of NIV are presented.
