Noninvasive positive pressure ventilation (NIPPV) delivered by a nasal or face mask is increasingly being used in the management of patients with acute respiratory failure. Total 45 patients (29 males, 16 females) with mean age 68.32 years (range 29 to 82 years) having acute onset hypoxemic and/or hypercapnic respiratory failure managed with NIPPV in a tertiary care center of Armed Forces were studied. Patients with hemodynamic instability, coma and uncooperative patients were excluded from study. Etiology of Acute Respiratory Failure was acute exacerbations of COPD in 29 patients, ARDS-4 patients, severe kyphoscoliosis-2 patients, ILD-4 patients, lung contusion with pneumonia – 1 patient thoracoplasty – 1 patient and difficult weaning in 4 patients. Initial resting arterial blood gases showed mean PaO2 of 61 mmHg (Range 45 to 78 mmHg) mean PaCO2 –75.2 mmHg (range 32 to 127 mmHg) and mean PH-7.26 (range 7.03 to 7.45). Mean IPAP pressure was 14 cmH2O (Range 10 to 20 cmH2O). Mean EPAP was 5.8 cmH2O (Range 4 to 8 cmH2O). On average, NIPPV was required for 5.4 days (Range 2 to 15 days) prior to discharge. Eleven Patients required long term intermittent NIPPV along with domiciliary oxygen therapy. Total 9 patients died out of which 4 patients had advanced interstitial lung disease. Conclusion : NIPPV has been found useful in acute respiratory failure due to acute exacerbations of COPD, thoracic wall abnormalities and ARDS. It has not been found useful in hypoxemic respiratory failure due to interstitial lung disease and diffuse interstitial pneumonia.

A case of mixed dust pneumoconiosis -silicosiderosis is reported.