Table of ContentsView AllTable of ContentsPurpose and UsesHow It WorksForms of NPPVEffectivenessContraindications

Table of ContentsView All

View All

Table of Contents

Purpose and Uses

How It Works

Forms of NPPV

Effectiveness

Contraindications

Noninvasive positive pressure ventilation (NPPV) is a type of mechanical ventilation that can be used at home to assist with taking a full breath and maintaining adequate oxygen supply in the body, especially while sleeping.

If you have a health condition that causes you to have trouble breathing, such as sleep apnea orchronic obstructive pulmonary disorder (COPD), your healthcare provider may recommend noninvasive ventilation to help support your lung function.

You may already be familiar with noninvasive positive pressure ventilation if you have used a continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), or auto-adjusting positive airway pressure (APAP) machine.

Somsak Bumroongwong / EyeEm / Getty Images

Man Wearing Cpap Mask While Suffering From Sleep Apnea On Bed At Home

Noninvasive ventilation can provide you with ventilatory support through your upper airways. NPPV is an alternative toinvasive mechanical ventilation(being placed on a ventilator) for people who have chronic respiratory insufficiency orrespiratory failureand can no longer breathe adequately on their own.

NPPV is used to manage breathing in the following conditions:

Your healthcare provider may recommend NPPV for you if you have COPD and are experiencing an exacerbation that may result inhypercapnic respiratory failure(higher than normal carbon dioxide level in the blood), or if you have moderate to severe sleep apnea (brief interruptions in breathing during sleep).

You may also need NPPV if you havedyspnea(the sensation of shortness of breath),tachypnea(a rapid respiratory rate), and/or hypercarbia with a pH of between 7.25 and 7.35(normal body pH is between 7.35 to 7.45).

NPPV can be used as a transition tool as you move off of invasive mechanical ventilation, or in place of endotracheal intubation in some situations.

Unlike invasive ventilation, which requires monitoring in the intensive care unit, noninvasive ventilation can frequently be used in the general hospital ward, provided the staff is appropriately trained in its use. And it can be used at home in many situations too.

Using this ventilatory support, the alveoli stay slightly inflated after you breathe out, making their expansion easier with your next breath.

There are several forms of noninvasive positive pressure ventilation, including CPAP, BiPAP, and APAP. All three deliver pressurized oxygen through a mask, though they vary in their settings.

Comparing CPAP and BiPAP and Adjustable Airway Pressure

A 2014 research paper published inLancetfound that NPPV improved survival rates in people with COPD who had hypercapnia and respiratory acidosis (slightly lower than normal blood pH). The yearlong, randomized, multi-center, multinational study found that people with COPD who received noninvasive ventilation had a lower risk of death.

Other studies show that NPPV used during acuteCOPD exacerbationsreduces the need for endotracheal intubation and is associated with a lower rate of treatment failure and shorter hospital stays.

In addition, a 2016 study found that long-term NPPV may result in improvements inarterial blood gas(ABG), lung function, and health-related quality of life. In general, these improvements were much better with high-intensity noninvasive ventilation (using the highest possible inspiratory pressure) than with low-intensity NPPV.

NPPV may be contraindicated or would be used with caution if any of the following apply:

A Word From Verywell

NPPV can be beneficial in some circumstances, but it is not always the right solution. Your healthcare provider can determine if you are a candidate for noninvasive ventilation.

That said, NPPV can reduce the need for endotracheal intubation and improve survival rates for some people with COPD. It can improve blood gas values, lung function, and quality of life, particularly with high-flow NPPV. NPPV therapy can also be highly beneficial in the management of sleep apnea.

NPPV is one of many strategies that can improve your quality of life if you have COPD, sleep apnea, or obesity hypoventilation syndrome. Be sure to talk to your healthcare provider about other lifestyle changes that may help.

SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kasper D, Fauci A, Hauser S, Longo D, Jameson J.Harrison’s Principles of Internal Medicine.New York: McGraw-Hill Education, 2015. Print.Kohnlein T, Windisch W, Kohler D, et al.Non-Invasive Positive Pressure Ventilation for the Treatment of Severe Stable Chronic Obstructive Pulmonary Disease: A Prospective, Multicentre, Randomised, Controlled Clinical Trial.The Lancet. Respiratory Medicine. 2014. 2(9):698-705. doi:10.1016/S2213-2600(14)70153-5Windisch W, Storre J, Kohnlein T.Nocturnal Non-Invasive Positive Pressure Ventilation for COPD.Expert Reviews of Respiratory Medicine. 2015. 9(3):295-308. doi:10.1586/17476348.2015.1035260Altintas, N.Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.COPD. 2016. 13(1):1110-21.

Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kasper D, Fauci A, Hauser S, Longo D, Jameson J.Harrison’s Principles of Internal Medicine.New York: McGraw-Hill Education, 2015. Print.Kohnlein T, Windisch W, Kohler D, et al.Non-Invasive Positive Pressure Ventilation for the Treatment of Severe Stable Chronic Obstructive Pulmonary Disease: A Prospective, Multicentre, Randomised, Controlled Clinical Trial.The Lancet. Respiratory Medicine. 2014. 2(9):698-705. doi:10.1016/S2213-2600(14)70153-5Windisch W, Storre J, Kohnlein T.Nocturnal Non-Invasive Positive Pressure Ventilation for COPD.Expert Reviews of Respiratory Medicine. 2015. 9(3):295-308. doi:10.1586/17476348.2015.1035260Altintas, N.Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.COPD. 2016. 13(1):1110-21.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kasper D, Fauci A, Hauser S, Longo D, Jameson J.Harrison’s Principles of Internal Medicine.New York: McGraw-Hill Education, 2015. Print.Kohnlein T, Windisch W, Kohler D, et al.Non-Invasive Positive Pressure Ventilation for the Treatment of Severe Stable Chronic Obstructive Pulmonary Disease: A Prospective, Multicentre, Randomised, Controlled Clinical Trial.The Lancet. Respiratory Medicine. 2014. 2(9):698-705. doi:10.1016/S2213-2600(14)70153-5Windisch W, Storre J, Kohnlein T.Nocturnal Non-Invasive Positive Pressure Ventilation for COPD.Expert Reviews of Respiratory Medicine. 2015. 9(3):295-308. doi:10.1586/17476348.2015.1035260Altintas, N.Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.COPD. 2016. 13(1):1110-21.

Kasper D, Fauci A, Hauser S, Longo D, Jameson J.Harrison’s Principles of Internal Medicine.New York: McGraw-Hill Education, 2015. Print.

Kohnlein T, Windisch W, Kohler D, et al.Non-Invasive Positive Pressure Ventilation for the Treatment of Severe Stable Chronic Obstructive Pulmonary Disease: A Prospective, Multicentre, Randomised, Controlled Clinical Trial.The Lancet. Respiratory Medicine. 2014. 2(9):698-705. doi:10.1016/S2213-2600(14)70153-5

Windisch W, Storre J, Kohnlein T.Nocturnal Non-Invasive Positive Pressure Ventilation for COPD.Expert Reviews of Respiratory Medicine. 2015. 9(3):295-308. doi:10.1586/17476348.2015.1035260

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