The role of noninvasive ventilation in cancer patients with acute respiratory failure

The poor prognosis of ventilated patients with cancers, especially hematological malignancies, has been a major incentive in the use non-invasive ventilation in such patients. With experience of more than a decade, a few recommendations can be made. While experience in non invasive ventilation is of prime importance, it is the early use especially in conditions requiring supplemental oxygen and a drop in SaO of > 10% that 2 the most benefit is expected. Use of the helmet to provide noninvasive ventilation (NIV) may improve patient compliance. With appropriate use during diagnostic bronchoscopy, NIV may prevent endotracheal intubation. NIV has also been shown to provide relief from dyspnoea to a select group of do-not-intubate patients. While outcome in this group of patients is poor, appropriate use of NIV has been shown to reduce mortality. The coming years and more experience will improve our understanding and re fine the use of this modality in this critical condition.