This article is part of a series on Ventilator strategy, edited by John J Marini.

Review

Clinical review: Noninvasive ventilation in the clinical setting – experience from the past 10 years

Massimo Antonelli¹ , Mariano Alberto Pennisi² and Luca Montini³

¹  Professor of Intensive Care and Anesthesiology, Unità Operativa di Rianimazione e Terapia Intensiva, Istituto di Anestesia e Rianimazione, Policlinico Universitario A Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy

²  Assistant Professor of Intensive Care and Anesthesiology, Unità Operativa di Rianimazione e Terapia Intensiva, Istituto di Anestesia e Rianimazione, Policlinico Universitario A Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy

³  Research Fellow, Unità Operativa di Rianimazione e Terapia Intensiva, Istituto di Anestesia e Rianimazione, Policlinico Universitario A Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy

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Critical Care 2005, 9:98-103doi:10.1186/cc2933

Published:	25 August 2004

Abstract

This brief review analyses the progress of noninvasive ventilation (NIV) over the last decade. NIV has gained the dignity of first line intervention for acute exacerbation of chronic obstructive pulmonary disease, assuring reduction of the intubation rate, rate of infection and mortality. Despite positive results, NIV still remains controversial as a treatment for acute hypoxemic respiratory failure, largely due to the different pathophysiology of hypoxemia. The infection rate reduction effect achieved by NIV application is crucial for immunocompromised patients for whom the endotracheal intubation represents a high risk. Improvements in skills acquired with experience over time progressively allowed successful treatment of more severe patients.