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Editorials |

Noninvasive Ventilation for Acute Respiratory Failure : But How Severe?

Erik Garpestad, MD; Nick Hill, MD, FCCP
Author and Funding Information

Affiliations: Boston, MA
 ,  Drs. Garpestad and Hill are affiliated with Tufts-New England Medical Center.

Correspondence to: Erik Garpestad, MD, Tufts-New England Medical Center, Boston MA; e-mail: EGarpestad@tufts-nemc.org



Chest. 2005;128(6):3790-3791. doi:10.1378/chest.128.6.3790
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Over 15 years have passed since the publication of the initial report1 of noninvasive mechanical ventilation (NIV) to avoid endotracheal intubation in patients with acute respiratory failure (ARF). Since then, we have gained much knowledge supporting the use of NIV in a variety of clinical situations. NIV to treat patients with hypercapnic respiratory failure due to COPD is considered a “standard of care,”23 and there is general consensus that treatment with NIV should be strongly considered in patients with acute pulmonary edema (APE) and pneumonia in immunocompromised hosts,4 and is an option in a number of other clinical scenarios. Many questions remain, however, including the issue of whether there is a severity of ARF beyond which NIV should not be used.

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