title: "NIV (Non-Invasive Ventilation)"
NIV (Non-Invasive Ventilation)
Key Facts
NIV (BiPAP) improves outcomes in acute hypercapnic respiratory failure from COPD exacerbation.
Do not use NIV if the patient cannot protect their airway (e.g. vomiting, reduced consciousness).
Overview
This article covers when to use NIV, major contraindications, and practical ED considerations.
Indications
- COPD exacerbation with acute hypercapnia and respiratory acidosis
- Cardiogenic pulmonary oedema (often CPAP)
- Selected immunocompromised patients with hypoxaemic respiratory failure (context-dependent)
Contraindications (common)
- Inability to protect airway (vomiting, active GI bleed with aspiration risk)
- Reduced consciousness / agitation preventing mask tolerance
- Facial trauma / upper airway obstruction
- Haemodynamic instability
Sources
- CC Bible
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Related Topics
See also: COPD Exacerbation, Respiratory Failure: Type 1 & Type 2, Mechanical Ventilation Basics