ATS/ERS Noninvasive Ventilation For Acute Respiratory Failure Guideline Summary - Guideline Central
Treatment
Document Overview

Noninvasive Ventilation For Acute Respiratory Failure

American Thoracic Society

European Respiratory Society


Publication Date: Aug 1, 2017

Page Last Updated: May 5, 2026

Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-Based Recommendations

Implications for:Strong Recommendation (S)Conditional Recommendation (C)
PatientsMost individuals in this situation would want the recommended course of action, and only a small proportion would not.The majority of individuals in this situation would want the suggested course of action, but many would not.
CliniciansMost individuals should receive the intervention. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.
PolicyThe recommendation can be adopted as policy in most situations.Policymaking will require substantial debate and involvement of various stakeholders.
Certainty in the Evidence
HighHLowL
ModerateMVery LowVL

Source: Grading of Recommendations Assessment, Development and Evaluation Working Group (Schunemann HJ et al. Am J Respir Crit Care Med. 2006;174:605-14. Guyatt GH et al. BMJ 2008;336:924-6).

Document Overview

Document Title
Noninvasive Ventilation For Acute Respiratory Failure
Authoring Societies

American Thoracic Society

European Respiratory Society

Document Publication Date
Aug 1, 2017
Page Last Reviewed/Updated
May 5, 2026
Document Type
Guideline
Country of Publication
Global
Full Text Freely Available
Yes
Full Text Guideline
erj.ersjournals.com/content/50/2/1602426.long
Source Citation

Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017; 50.

The guidelines were a cooperative effort among the American Thoracic Society and the European Respiratory Society.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives
The purpose of the current European Respiratory Society (ERS)/American Thoracic Society (ATS) guidelines is to provide evidence-based recommendations on the application of noninvasive ventilation (NIV) in acute respiratory failure (ARF). 
Scope
Management, Treatment
Diseases/Conditions (MeSH)

D063087 - Noninvasive Ventilation

D063087 - Noninvasive Ventilation

Keywords
ARF, acute respiratory failure, noninvasive ventilation
Inclusion Criteria
Male, Female, Adult, Older Adult
Health Care Settings
Emergency Care, Hospital
Intended Users
Nurse, Nurse Practitioner, Physician, Physician Assistant, Respiratory Therapist

Recommendation Development Processes & Methodology

PICO Questions
  1. Should NIV be used in COPD exacerbation?
  2. Should NIV be used in ARF due to a COPD exacerbation to prevent the development of respiratory acidosis?
  3. Should NIV be used in established acute hypercapnic respiratory failure due to a COPD exacerbation?
  4. Should NIV be used in ARF due to cardiogenic pulmonary oedema?
  5. Should a trial of CPAP prior to hospitalisation be used to prevent deterioration in patients with ARF due to cardiogenic pulmonary oedema?
  6. Should NIV be used in ARF due to acute asthma?
  7. Should NIV be used for ARF in immunocompromised patients?
  8. Should NIV be used in de novo ARF?
  9. Should NIV be used in ARF in the post-operative setting?
  10. Should NIV be used in patients with ARF receiving palliative care?
  11. Should NIV be used in ARF due to chest trauma?
  12. Should NIV be used in ARF due to pandemic viral illness?
  13. Should NIV be used in ARF following extubation from invasive mechanical ventilation?
  14. Should NIV be used to prevent respiratory failure post-extubation?
  15. Should NIV be used in the treatment of respiratory failure that develops post-extubation?
  16. Should NIV be used to facilitate weaning patients from invasive mechanical ventilation?
Supplemental Methodology Resources
Technical Review Evidence Tables Methodology Supplement
Number of Source Documents
143
Includes peer/external review process?
Yes
Includes public comment process?
No
Methodologist involvement?
Yes
Patient involvement?
No
Includes multi-disciplinary group?
Yes
Includes systematic review?
Yes
Grades quality of strength of evidence?
Yes
Grades quality of strength of recommendation?
Yes
Discloses funding source?
Yes
Discloses conflicts of interest?
Yes
Includes benefits/harms analysis with recommendations?
Yes
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