Noninvasive ventilation during acute respiratory distress syndrome in patients with cancer—what really matters

Noninvasive ventilation (NIV) is used to provide ventilator support with the aim of avoiding the complications of invasive mechanical ventilation. These include direct lesions of the patients’ pharyngeal, laryngeal and tracheal structures, and, more importantly, nosocomial infections. Of the latter, ventilator-associated pneumonia (VAP) is the most relevant, but the need for sedation to tolerate the invasive airway and the more invasive monitoring may result in increased infectious complications outside the lungs as well (1,2). Groups of patients who benefit most from NIV include exacerbation of chronic obstructive pulmonary disease (COPD), acute cardiogenic pulmonary edema, and patients with immunosuppression (1-3).