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Beyond the guidelines for non-invasive ventilation in acute respiratory failure: implications for practice

Lookup NU author(s): Professor Stephen BourkeORCiD


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© 2018 Elsevier Ltd Non-invasive ventilation is standard therapy in the management of both hypoxaemic and hypercapnic respiratory failure of various causes. The evidence base for its use and when and how it should be used has been reviewed in two recent guidelines. In this Series paper, we look beyond the guidelines to what is happening in everyday clinical practice in the real world, how patient selection can be refined to maximise the chances of a successful outcome, and emerging alternative therapies. Real-world application of non-invasive ventilation diverges from guideline recommendations, particularly with regard to patient selection and timing of initiation. To improve patient outcomes education programmes need to stress these issues and the effectiveness of non-invasive ventilation that is delivered needs to be monitored by regular audit.

Publication metadata

Author(s): Bourke SC, Piraino T, Pisani L, Brochard L, Elliott MW

Publication type: Review

Publication status: Published

Journal: The Lancet Respiratory Medicine

Year: 2018

Volume: 6

Issue: 12

Pages: 935-947

Online publication date: 23/11/2018

Acceptance date: 02/04/2018

ISSN (print): 2213-2600

ISSN (electronic): 2213-2619

Publisher: Lancet Publishing Group


DOI: 10.1016/S2213-2600(18)30388-6