• Crit Care · Jan 2006

    Comment Review

    Noninvasive ventilation for acute lung injury: how often should we try, how often should we fail?

    • Erik Garpestad and Nicholas S Hill.
    • Division of Pulmonary, Critical Care and Sleep Medicine, Tufts-New England Medical Center, Washington St, Boston, MA 02111, USA.
    • Crit Care. 2006 Jan 1;10(4):147.

    AbstractThe selection of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) to receive noninvasive ventilation (NIV) is challenging, partly because there are few reliable selection criteria. The study by Rana and colleagues in the previous issue of Critical Care identifies metabolic acidosis and a lower oxygenation index as predictors of NIV failure, although it is unable to identify threshold values. It also demonstrates that treating patients with NIV for ALI/ARDS and shock is an exercise in futility. Future studies need to focus on criteria that will enable selection of patients for whom NIV will have a high likelihood of success.

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