Noninvasive ventilation

Several mRCTs showed that NIV could have a beneficial effect on survival. Non-invasive ventilation should be considered to treat ARF, mainly in hypercapnic patients and at an early stage. Non-invasive ventilation could also reduce mortality when applied in the weaning process, particularly in hypercapnic patients after a failed T-piece trial or after control of pulmonary infection. Non-invasive ventilation can improve survival when applied to prevent post extubation failure in patients at high-risk of failure. On the contrary, NIV could be harmful if applied to treat an established post extubation ARF. More research is warranted to evaluate NIV in other fields and in controversial areas; furthermore, authors should evaluate the best way to offer safe and cost-effective NIV to all those who could benefit.