Noninvasive ventilation versus oxygen therapy for the treatment of acute respiratory failure

ABSTRACT

Introduction: There is an ongoing discussion on whether oxygen therapy or noninvasive ventilation (NIV) should be used in patient with acute respiratory failure. While respiratory acidosis, especially in case of COPD exacerbation, is a clear indication for NIV, data available in patients with acute hypoxemic respiratory failure (AHRF) are ambiguous. In addition, recently the use of nasal high flow (NHF) has been increased. Despite that NHF has been studied as an alternative to NIV, the clinical advantages of NHF need to be confirmed.

Areas covered: The purpose of this review is to enhance our understanding about the management of AHRF in specific settings, focusing on recent papers in which NIV and standard oxygen or NHF have been compared.

Expert commentary: The choice of the most appropriate strategy for AHRF treatment should be made based upon patient’s clinical status, underlying diseases, level of required respiratory support and patient’s tolerance and comfort.

KEYWORDS:

• Acute respiratory failure
• non invasive ventilation
• oxygen therapy
• hypoxemia
• nasal high flow

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.