The use of NPPV for support during the treatment of respiratory failure is attractive because it does not require either endotracheal intubation or deep sedation and can be safely initiated or discontinued as needed. It is also associated with few of the nosocomial complications recognized with endotracheal intubation, such as ventilator-associated pneumonia, critical illness-associated weakness, pneumothorax, delirium, and infections associated with the invasive monitoring that is typically required during invasive life support.4,8 NPPV is not appropriate for some patients, such as those with cardiopulmonary arrest or shock, where greater airway control is required, or facial trauma, where the interface (e.g., mask) cannot be used appropriately.