Trends of Noninvasive Ventilation: Epidemiology Insights

Abstract

Noninvasive ventilation (NIV) is a standard method of ventilation in patients with respiratory failure (RF) in different healthcare areas or at home (Díaz Lobato and Mayoralas Alises, Arch Bronconeumol 49:475–9, 2013), especially in the past few years when most guides have included NIV as a standard of care in different acute or chronic pathologies. The appearance over time of different types of ventilation has meant that, initially NIV was only used in patients with diverse types of hypoventilation, such as home treatment; in the following years, NIV was an alternative treatment in acute hypercapcnic RF, and finally, it has become as an initial or definitive alternative to intubation, especially in patients with comorbidities in intensive care units (ICU) or in hospital wards, highlighting its role during the COVID-19 pandemic (Cortegiani et al., Critical Care 24:692, 2020). Recently, NIV has also become an alternative in pediatric ICUs, specifically in the management of bronchiolitis or asthma exacerbation.

Several trials and reviews show that NIV use and success rate has increased. The main problem with NIV is the tolerability, and improvement in this field is being sought to obtain greater benefit from its management, and consequently giving rise to a greater use of NIV. In the past few years, high flow nasal cannula (HFNC) has replaced NIV as an alternative initial management of RF, especially in hypoxemic RF, and it is expected that this will persist over time due to its greater tolerability and similar efficacy in different types of RF.

In conclusion, the trend of NIV in recent years has been growing, although we cannot guarantee that this trend will continue in the coming years in detriment to HFNC; it is therefore fundamental to improve the selection of patients who would benefit from NIV and the interface that allows a good adaptation and consequently a better therapeutic adherence.