• Rajesh Chawla, Subhal B Dixit, Kapil Gangadhar Zirpe, Dhruva Chaudhry, G C Khilnani, Yatin Mehta, Khalid Ismail Khatib, Bharat G Jagiasi, Gunjan Chanchalani, Rajesh C Mishra, Srinivas Samavedam, Deepak Govil, Sachin Gupta, Shirish Prayag, Suresh Ramasubban, Jayesh Dobariya, Vikas Marwah, Inder Sehgal, Sameer Arvind Jog, and Atul Prabhakar Kulkarni.
• Department of Respiratory and Critical Care Medicine, Indraprastha Apollo Hospitals, New Delhi, India, , e-mail: drchawla@hotmail.com.
• Indian J Crit Care Med. 2020 Jan 1; 24 (Suppl 1): S61-S81.

AbstractA. ACUTE HYPERCAPNIC RESPIRATORY FAILURE A1. Acute Exacerbation of COPD: Recommendations: NIV should be used in management of acute exacerbation of COPD in patients with acute or acute-on-chronic respiratory acidosis (pH = 7.25-7.35). (1A) NIV should be attempted in patients with acute exacerbation of COPD (pH <7.25 & PaCO2 ≥ 45) before initiating invasive mechanical ventilation (IMV) except in patients requiring immediate intubation. (2A). Lower the pH higher the chance of failure of NIV. (2B) NIV should not to be used routinely in normo- or mildly hyper-capneic patients with acute exacerbation of COPD, without acidosis (pH > 7.35). (2B) A2. NIV in ARF due to Chest wall deformities/Neuromuscular diseases: Recommendations: NIV may be used in patients of ARF due to chest wall deformity/Neuromuscular diseases. (PaCO2 ≥ 45) (UPP) A3. NIV in ARF due to Obesity hypoventilation syndrome (OHS): Recommendations: NIV may be used in AHRF in OHS patients when they present with acute hypercapnic or acute on chronic respiratory failure (pH 45). (3B) NIV/CPAP may be used in obese, hypercapnic patients with OHS and/or right heart failure in the absence of acidosis. (UPP) B.Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

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