Sedation and Noninvasive Positive Pressure Ventilation-Where are We now? A Narrative Review

Noninvasive positive pressure ventilation (NIV) is an important tool for treating the critically ill. Unfortunately, NIV intolerance is a potential reason why patients will fail NIV and have to be intubated and invasively mechanically ventilated. Providing sedation is a possible solution to improve intolerance. While many sedative/analgesic options exist such as dexmedetomidine, ketamine, opioids, benzodiazepines, or propofol, little research is available to guide these choices. Because of the paucity of data, there are no clinical practice guideline recommendations to assist the clinician.