Noninvasive respiratory support has been a proven intervention for patients with acute respiratory failure. CPAP, noninvasive ventilation, and high-flow nasal cannula have been effectively used to support the respiratory needs of this patient population. Even with the application of these devices over many years, however, some patients are not successfully managed on noninvasive support modalities. Many factors can lead to failure of these interventions, several of which impact patient-ventilator synchrony. This paper reviews these factors, along with other issues that may impact tolerance of these devices. By addressing these factors and tailoring the intervention to the needs of the individual patient, the clinician can improve the likelihood of successful management of the respiratory condition in the patient with acute respiratory failure who receives noninvasive respiratory support.
Keywords: asynchrony; continuous positive airway pressure; high-flow nasal cannula; noninvasive ventilation; patient comfort; patient education.
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