Noninvasive ventilation

Noninvasive Positive Pressure Ventilation (NIMV) has significantly changed the approach to respiratory failure in the last two decades. NIMV has found increasing applications and widespread acceptability. It has proven value in reducing the intubation rate, mortality and length of hospital stay in acute decompensations in patients of chronic obstructive pulmonary disease (COPD). NIMV has been applied for respiratory failure in a wide variety of acute and chronic respiratory conditions where its beneficial effects are yet to be established. There are clear indications that NIMV may expedite weaning from mechanical ventilation in a substantial proportion of COPD patients. NIMV is shown to be easy to apply even in non-ICU setting by trained nursing and paramedical personnel. The past decade has witnessed improving technology of the noninvasive ventilation devices, as well as mask design and material. Several questions on the application of NIMV remain such as its precise role in conditions other than COPD, early markers of failure, and the timing of the application.