Should noninvasive positive-pressure ventilation be used in all forms of acute respiratory failure?

Dean R. Hess, Henry E. Fessler

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Noninvasive positive-pressure ventilation (NPPV) has been a major advance in the management of acute respiratory failure. Over the past decade alone, NPPV has been the subject of over 1,500 scientific papers, including 14 meta-analyses. NPPV's utility in many clinical settings has been well established, with demonstration in randomized trials of lower intubation rate, mortality, hospital stay, and advantages in other important clinical outcomes. However, it is still used in a minority of patients with acute respiratory failure. While there probably are situations in which NPPV is commonly under-utilized, there are other situations in which it is unlikely to be of benefit or likely to inflict harm. This paper debates the data for and against the more widespread application of NPPV. It will assist the clinician to identify both good and poor candidates for NPPV and thereby devote respiratory care resources where they will be most effective, and optimize patient outcomes.

Original languageEnglish (US)
Pages (from-to)568-578
Number of pages11
JournalRespiratory care
Issue number5
StatePublished - May 2007


  • Chronic obstructive pulmonary disease
  • Mechanical ventilation
  • Meta-analysis
  • Noninvasive positive-pressure ventilation
  • Noninvasive ventilation
  • Pulmonary edema
  • Respiratory failure
  • Weaning

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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