Noninvasive positive pressure ventilation in acute hypoxemic respiratory failure and in cancer patients

Acute respiratory failure (ARF) is a common occurrence in cancer patients and is associated with a high mortality rate. The role of NPPV in immunosuppressed, hematological malignancies, and solid tumor is an area that interests researchers and clinicians alike. Several randomized controlled trials and systematic reviews have confirmed the benefits of noninvasive positive pressure ventilation (NPPV) in patients with exacerbation of chronic obstructive pulmonary disease (COPD). Benefits achieved from NPPV in COPD patients are largely due to avoidance of invasive mechanical ventilation (IMV) and its complications including worsening of preexisting infections, morbidity and mortality, ventilator associated pneumonia (VAP), ventilator associated lung injury, increased need for sedation resulting in prolonged ventilation, ventilator dependence, and upper airway complications related to endotracheal tube [1]. The use of NPPV in COPD with hypercapneic ARF is no longer debated and is now considered as first-line intervention before considering endotracheal intubation (ETI) and IMV.