What are the contraindications to NIV?

Question

Accepted Answer

Contraindications to NIV can be absolute or relative. Absolute contraindications include reduced consciousness or inability to protect the airway, ongoing vomiting or high aspiration risk, facial trauma or deformity preventing mask seal, untreated pneumothorax, and cardiac or respiratory arrest. Relative contraindications include severe agitation or poor cooperation, haemodynamic instability, copious secretions, and recent upper GI surgery. In such cases I would involve ICU early and consider whether invasive ventilation is more appropriate. The key principle is that NIV requires a cooperative patient with an intact airway and stable haemodynamics.

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