Mechanical ventilation can cause lung injury and increase patient morbidity and mortality.
Noninvasive ventilation (NIV) is well-known to decrease intubation rates and improve patient outcome in select disease states (i.e., COPD, acute CHF).
For patients with acute respiratory distress syndrome (ARDS), NIV may reduce the work of breathing by opening collapsed alveoli, increasing FRC, and improving oxygenation.
To date, there are only a few RCTs that have evaluated the use of NIV in ARDS.
Unfortunately, these trials have failed to demonstrate improved patient outcome or decreased intubation rates in patients with ARDS.
Clinical Bottom Line: Intubate patients with ARDS who are difficult to oxygenate with standard oxygen therapy.
References
Demoule A, et al. Can we prevent intubation in patients with ARDS? Intensive Care Med 2016; 42:768-771.
