Table 1 Indications and contraindications for NIV in acute care[4, 16, 17, 35]
From: Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
Indications: | |
A- Gas exchange: | |
 • | Acute or acute on chronic ventilator failure (best indication), PaCO2 > 45 mmHg |
 • | Ph < 7.35 |
 • | Hypoxemia (use with caution), PaO2/FIO2 ratio < 200 |
B- Bedside observations: | |
 • | Increased dyspnea- moderate to severe |
 • | Tachypnoea (24 breaths per minute in obstructive, >30 per minute in restrictive) |
 • | Signs of increased work of breathing, accessory muscle use, and abdominal paradox |
Absolute contraindications: | |
 • | Cardiac or respiratory arrest |
 • | Unable to fit mask |
Relative contraindications: | |
 • | Non-respiratory organ failure (severe encephalopathy with GCS < 10, severe upper gastrointestinal bleeding, hemodynamic instability or unstable cardiac arrthythmia) |
 • | Inability to cooperate/protect the airway |
 • | Inability to clear respiratory secretions |
 • | High risk of aspiration |
 • | Recent facial surgery, trauma, or deformity |
 • | Upper airway obstruction |