Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications

Indications for NIV:

 • COPD - pH <7.35, pCO2 >6.5, RR > 23 - If persisting after bronchodilators and controlled oxygen therapy

 • Neuromuscular disease - Respiratory illness with RR if usual VC < 1 even if pCO2 < 6.5 or pH <7.35 and pCO2 >6.5

 • Obesity - pH <7.35, pCO2 >6.5 and RR or daytime pCO2 > 6.0 and somnolent

Contraindications for NIV:

  • Absolute: Severe facial deformity, Facial burns, Fixed upper airway obstruction

  • Relative: pH <7.15 (pH <7.25 and additional adverse feature), GCS, Confusion/agitation, Cognitive impairment (warrants enhanced observation)



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