What are contraindications for noninvasive ventilation (NIV)?

Updated: Jun 18, 2020
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Absolute contraindications are as follows:

  • Coma

  • Cardiac arrest

  • Respiratory arrest

  • Any condition requiring immediate intubation

Other contraindications (rare exceptions) are as follows:

  • Cardiac instability - Shock and need for pressor support, ventricular dysrhythmias, complicated acute myocardial infarction

  • GI bleeding - Intractable emesis and/or uncontrollable bleeding

  • Inability to protect airway - Impaired cough or swallowing, poor clearance of secretions, depressed sensorium and lethargy

  • Status epilepticus

  • Potential for upper airway obstruction - Extensive head and neck tumors, any other tumor with extrinsic airway compression, angioedema or anaphylaxis causing airway compromise

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