NIPPV delivers oxygen at either constant or variable pressures via a face mask, with common methods including Bi-level Positive Airway Pressure (BiPAP) and Continuous Positive Airway Pressure (CPAP). BiPAP provides different airway pressures during inspiration and expiration, assisting in ventilation by ensuring that iPAP supports the primary breathing effort while ePAP aids in recruiting underventilated or collapsed alveoli for gas exchange and the removal of exhaled gas. NIPPV is used for conditions such as acute exacerbation of chronic obstructive pulmonary disease (AECOPD), acute respiratory failure secondary to cardiogenic pulmonary edema, postoperative respiratory failure, chest trauma, and various chronic respiratory diseases. It is contraindicated in cases of facial trauma, fixed upper airway obstruction, active vomiting, and respiratory or cardiac arrest, while relative contraindications include recent facial or upper airway surgery, inability to protect the airway, life-threatening hypoxemia, and medical or hemodynamic instability.

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Initiating and titrating NIPPV requires careful patient selection, mask fitting, and close monitoring by experienced clinicians, respiratory therapists, and critical care nurses. The process involves explaining the procedure to the patient, allowing them to acclimate to the mask, and then gradually adjusting the ventilator settings. Continuous monitoring of the patient's response, including respiratory rate, heart rate, blood gases, and hemodynamics, is essential to ensure the effectiveness and safety of NPPV. NPPV has been shown to significantly reduce intubation rates and improve outcomes in conditions like COPD, cardiogenic pulmonary edema, and pneumonia.