Noninvasive ventilation: open issues for nursing research

Noninvasive ventilation: open issues for nursing research


  • Stefano Bambi University of Florence; Emergency &Trauma Intensive Care Unit, Careggi Teaching Hospital, Florence, Italy
  • Enrica Mati University of Florence; Emergency &Trauma Intensive Care Unit, Careggi Teaching Hospital, Florence, Italy
  • Christian De Felippis Cardiothoracic Surgery, Glenfield Hospital, University Hospital of Leicester-NHS Trust, Leicester, United Kingdom
  • Alberto Lucchini General Intensive Care Unit, ASST Monza - S. Gerardo Hospital, University of Milan-Bicocca, Italy


noninvasive ventilation, nursing research, outcome assessment (healthcare), qualitative research


According to the current literature, Noninvasive Ventilation (NIV) is a well-recognized respiratory support technique for patients affected by Acute Respiratory Failure (ARF). As highlighted by recent meta-analysis, a tight adherence to protocols regarding patients’ selection criteria, relative or absolute contraindications, plus highly skilled and experienced operators, can positively affect the NIV performance and mortality rates. Positive outcome from NIV respiratory support is dependent from: patient’s clinical condition and education needs; confidence of the staff with NIV technology; choice and management of the most suitable interface available prevention of interface complications; nutritional assessment (artificial feeding if required) and conditioning of medical gas. Despite these issues, the air leakage represents the major threat during NIV support. Indeed, to obtain a positive outcome from this treatment, the ‘NIV troubleshooting’ management appears to be crucial. Common issues as air leakage, patient-ventilator asynchrony, interface related pressure ulcers, discomfort, and gastric distention should be promptly detected and solved. The analysis of these current issues reveals a lack of evidence based practice, resulting in bed-side clinical interventions based only on the expert consensus or local opinions. To improve this knowledge gap, more efforts are strongly recommended from medical and nursing research communities. Multicenter randomized controlled clinical trials are needed to achieve adequate knowledge to reach the best patient’s outcome. Further information to identify new areas of nursing research on NIV, can be achieved from qualitative studies performed on patients and healthcare operators.






Original article: Nursing techniques and research

How to Cite

Noninvasive ventilation: open issues for nursing research. Acta Biomed [Internet]. 2017 Apr. 19 [cited 2024 Jun. 23];88(S1):32-9. Available from: