Noninvasive Ventilation in Patients with Do-Not-Intubate and Comfort-Measures-Only Orders

Noninvasive ventilation (NIV), including continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP), has been used in a number of conditions to manage acute respiratory failure and may prevent escalation to invasive mechanical ventilation. A systemic review and meta-analysis published last month in Critical Care Medicine assessed the effectiveness of noninvasive ventilation in patients with acute respiratory failure and do-not-intubate or comfort-measures-only orders. Investigators reported that 56% of patients survived to hospital discharge and 32% survived to 1 year, with limited data showing no decrease in quality of life in survivors.

Link to: Crit Care Med (8/2018) (Available from Medscape – free access with site registration)