UMEM Educational Pearls

  • 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


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.