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Noninvasive ventilation is the delivery of mechanical ventilation without the need for artificial airway through the larynx or trachea.The traditional method to administer noninvasive ventilation was through devices that generated negative pressures (i.e., noninvasive negative pressure ventilation), such as the cuirass or the iron lung.The next level of sophistication is the administration of two different levels of pressure, one for inspiration and one for the expiratory phase.As technology has advanced, so have the devices and the techniques that control how the delivery of pressure (mechanical breaths) are started (triggered), controlled (targeted), and ended (cycled).The term noninvasive positive pressure ventilation refers not only to the "mode," but to the fact that instead of using the traditional negative pressure (e.g., with an iron lung) now we use positive pressure to achieve ventilation.

In the past 2 decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions (coughing, swallowing, feeding, speech), decrease airway injury, and prevent respiratory tract infections.In the outpatient setting, it provides ventilatory support, again preserving normal physiologic functions while allowing ambulation, travel and care at home.In this review, we summarize the different modalities of this assisted ventilation technique, review their indications and contraindications in specific conditions both in the acute hospital setting and in chronic conditions managed at home.Back to Top The first step in understanding noninvasive mechanical ventilation is to understand the nomenclature.Thus, numerous modes of noninvasive ventilation are available, each with a proprietary brand name.

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The literature is plagued with different names and acronyms to refer to the same mode of ventilation (Table 1).

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