Non-Invasive Ventilation in Acute Respiratory Failure: Practical Approach, Troubleshooting and Common Pitfalls
- Dr. Chanurdi (P. G. C. K.) Wickramathunga — Doctor of Senior Registrar in Pulmonology and Respiratory Medicine at the National Hospital for Respiratory Diseases, Sri Lanka
Pulmonology · Critical Care
Non-invasive ventilation (NIV) is an important respiratory support strategy for selected patients with acute respiratory failure, helping improve ventilation and reduce the need for endotracheal intubation. Successful application requires appropriate patient selection, assessment of respiratory distress, understanding of indications and contraindications, and selection of suitable interfaces and ventilator settings. Close monitoring of oxygenation, ventilation, work of breathing and clinical response is essential to identify treatment failure early. Common challenges include mask leaks, patient–ventilator asynchrony, intolerance and inadequate support. Recognising these issues, troubleshooting effectively and escalating to invasive ventilation when indicated are crucial for safe patient management.