Table 2.

Contraindications for NIV in COVID patients.

Indication for invasive mechanical ventilation

Limited personnel experience with HFNC/NIV

Lack of capability of monitoring

Lack of infectious control and control of aerosolized transmission

Hemodynamic instability and cardiac arrhythmias

Multiple organ failure

Abnormal mental status or encephalopathy

Over-ventilation and “patient-induced lung injury” (PILI)

Cardiopulmonary arrest

Uncooperative patients

Inability to protect airways

Anatomical and/or subjective difficulties gaining access to the airway

Gastrointestinal bleeding, ileus, or risk for aspiration

Severe hypoxemia or acidosis (pH < 7.1)

Excessive secretions

Recent upper airway or upper gastrointestinal surgery

Severe hypoxemia on admission defined as PaO2/FiO2 < 150

Pneumothorax, pleural effusion, or pulmonary embolism

Recent facial trauma or facial surgery

SOFA score >5 is predictive of NIV failure

CXR/CT showing evidence of bilateral, multi-lobar involvement