Abstract
Noninvasive positive pressure ventilation (NPPV) refers to the delivery of mechanical ventilation to the lungs using techniques that do not require an endotracheal intubation. In the past decade NPPV has gained wide acceptance and is now used more frequently after development of portable ventilators, new modes of ventilation and other equipments. This article will provide a comprehensive overview of the current stage of NPPV in acute and chronic settings. It will appraise the evidence based efficacy of NPPV in patients who presented with acute exacerbation of chronic hypercapneic respiratory failure. The main focus of discussion in this article is to provide detailed knowledge regarding choosing appropriate ventilators and interfaces, selecting appropriate patients and initiating NPPV and their weaning.