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Noninvasive Positive-Pressure Ventilation for Acute Respiratory Failure: Comparative Effectiveness

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Uncertainties Related to the Use of NPPV for Managing Acute Respiratory Failure

Although noninvasive positive-pressure ventilation (NPPV) has been a readily available modality since the early 1990s and clinically important benefits for this strategy have been demonstrated in some trials, its use varies substantially across and within countries. Surveys in the United States have shown high variability in estimated use across hospitals. Barriers to using NPPV include:

  • A lack of physician knowledge
  • Low rates of perceived efficacy
  • Limited information on the potential benefits and adverse effects of NPPV for patients with acute respiratory failure for conditions other than chronic obstructive pulmonary disease or acute cardiogenic pulmonary edema

This systematic review aimed to address some of these gaps in knowledge.