Noninvasive Ventilation in Chronic Hypercapnic Respiratory Failure.

Noninvasive ventilation (NIV) is a cornerstone therapy for chronic hypercapnic respiratory failure arising from chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS), and neuromuscular disease (NMD). This article reviews the pathophysiology of ventilatory pump failure, key NIV mode features (continuous positive airway pressure, bilevel positive airway pressure-S/ST, volume-assured pressure support, auto-expiratory positive airway pressure), and advanced settings that govern patient-ventilator synchrony. It contrasts respiratory assist devices with home mechanical ventilators and links device choice to disease-specific needs.