Question 1

List the contraindications for and complications of non invasive ventilation.

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College Answer

a)  Respiratory arrest
b)  Unprotected airway (coma, sedation)
c)  Inability to clear secretions
d)  Marked hemodynamic instability
e)  Oesophageal surgery or maxillofacial surgery pathology (eg ruptured


a)  Mask discomfort,  patient intolerance
·  b)  Facial or ocular abrasions, pressure necrosis

c)  Aspiration pneumonitis.
d)  Aerophagy and gastric distension
e)  Oronasal dryness
t)  Raised intracranial pressure
g)  Hypotension if hypovolemic


Complications of non-invasive ventilation:

  • Mask intolerance, agitation and claustrophobia
  • Increased need for sedation
  • Delay of intubation
  • Aspiration
  • Poor clearance of secretions
  • Hypotension of hypovolemic patients
  • Facial pressure areas
  • Raised intracranial pressure
  • Aerophagy
  • Damage to facial, nasal and oesophageal surgical sites or traumatic injuries, leading to surgical emphysema, pneumothorax and pneumomediastinum

Contraindications of non-invasive ventilation

  • Decreased level of consciousness
  • Respiratory arrest
  • Vomiting
  • Hemodynamic instability
  • Poor clearance of secretions, eg. absent cough and gag
  • large sputum load and/or pneumonia
  • surgical or traumatic damage to the airways or oesophagus


Gay, Peter C. "Complications of noninvasive ventilation in acute care."Respiratory care 54.2 (2009): 246-258.