La ventilation non invasive au cours de l'insuffisance respiratoire aiguë

Non invasive positive pressure ventilation (NIPPV) has been widely developed in intensive care units. A positive expiratory pressure is coupled with mechanical triggered insufflations delivered through a facemask. Chronic obstructive disease acute failure and acute cardiogenic pulmonary oedema are validated indications of NIPPV. NIPPV requires further validation for acute hypoxaemic respiratory failure and weaning from mechanical ventilation. The efficacy of NIPPV depends on careful management. Correct application of the facemask adapted determination of ventilatory parameters such as inspiratory and expiratory thresholds and values of insufflation and expiratory pressures are critical to guarantee the success rate of the technique. Leaks around the facemask are frequent and challenging and may impair tolerance and efficacy of the technique. Failure of NIPPV needs to be rapidly recognized to avoid a life threatening delay in tracheal intubation.