Noninvasive Ventilation in the Perioperative Period

  • Jacopo Tramarin
  • Andrea Cortegiani
  • Cesare Gregoretti


High-flow nasal therapy (HFNT), as well as noninvasive ventilation (NIV), represents both noninvasive supports. HFNT is a ventilator support where humidified and heated gases are administered to the patient’s airways by a small nasal cannula at flow that reach up to 60 L/min. The delivered flow can be combined with oxygen providing different inspiratory oxygen fractions (FiO2). HFNT is increasingly used for critically ill adult patients in different clinical settings. Differently from noninvasive ventilation (NIV) which is intended to deliver intermittent positive pressure ventilation (NIPPV) or continuous positive airway pressure (CPAP) to the patient’s airway via different external interfaces, HFNT acts through different physiological mechanisms only partially associated to the production of an end-expiratory airway pressure. HFNT may have some advantages compared to NIV including possible better comfort, less need of workloads, and less equipment. However it deserves strict monitoring to avoid, in specific settings (e.g., hypoxemic patients), delay in escalating support and endotracheal intubation.

The aim of this review is to provide an overview, practical advices, and current evidence about the application of NIV and HFNT in perioperative medicine.


High-flow nasal therapy HFNT Noninvasive ventilation NIV CPAP NIPPV Perioperative medicine Oxygen 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jacopo Tramarin
    • 1
  • Andrea Cortegiani
    • 1
  • Cesare Gregoretti
    • 1
  1. 1.Section of Anesthesia, Analgesia, Intensive Care and Emergency, Department of Anesthesiology and Medical Biotechnologies (DIBIMED), Policlinico Paolo GiacconeUniversity of PalermoPalermoItaly

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