Noninvasive ventilation in intensive care

Non-invasive ventilation has been in use for many years to provide long-term home ventilatory support to patients with chronic respiratory failure. In recent years, it has emerged on the intensive care scene as a means of avoiding intubation in acute respiratory failure. The results of several studies indicate that such an approach can lead to a reduction in mortality and duration of hospital stay compared to conventional mechanical ventilation with endotracheal intubation. The purpose of this article is to explore the various ventilatory techniques available, the choice of respirator and ventilatory mode in various clinical conditions, and to discuss some of the logistics involved in the optimal use of this technique.