Evidence map›Paper›PMID 40725723›Full record

ReviewJournal of clinical medicine2025

Non-Invasive Ventilation: When, Where, How to Start, and How to Stop.

Mary Zimnoch, David Eldeiry, Oluwabunmi Aruleba, Jacob Schwartz, Michael Avaricio, Oki Ishikawa, Bushra Mina, Antonio Esquinas

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mary ZimnochDepartment of Pulmonary & Critical Care Medicine, Northwell Lenox Hill Hospital, New York, NY 10075, USA.
David EldeiryDepartment of Pulmonary & Critical Care Medicine, Northwell Lenox Hill Hospital, New York, NY 10075, USA.
Oluwabunmi ArulebaDepartment of Pulmonary & Critical Care Medicine, Northwell Lenox Hill Hospital, New York, NY 10075, USA.
Jacob SchwartzDepartment of Pulmonary & Critical Care Medicine, Northwell Lenox Hill Hospital, New York, NY 10075, USA.
Michael AvaricioDepartment of Pulmonary & Critical Care Medicine, Northwell Northern Westchester Hospital, New York, NY 10549, USA.
Oki IshikawaDepartment of Pulmonary & Critical Care Medicine, Northwell Northern Westchester Hospital, New York, NY 10549, USA.
Bushra MinaDepartment of Pulmonary & Critical Care Medicine, Northwell Northern Westchester Hospital, New York, NY 10549, USA.
Antonio EsquinasIntensive Care Unit, Hospital Meseguer, NIV-ICM, Instituto Murciano de Investigación Biosanitaria, 30008 Murcia, Spain.ORCID 0000-0003-0571-2050

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Non-invasive ventilation (NIV) is a cornerstone in the management of acute and chronic respiratory failure, offering critical support without the risks of intubation. However, successful weaning from NIV remains a complex, high-stakes process. Poorly timed or improperly executed weaning significantly increases morbidity and mortality, yet current clinical practice often relies on subjective judgment rather than evidence-based protocols. This manuscript reviews the current landscape of NIV weaning, emphasizing structured approaches, objective monitoring, and predictors of weaning success or failure. It examines guideline-based indications, monitoring strategies, and various weaning techniques-gradual and abrupt-with evidence of their efficacy across different patient populations. Predictive tools such as the Rapid Shallow Breathing Index, Lung Ultrasound Score, Diaphragm Thickening Fraction, ROX index, and HACOR score are analyzed for their diagnostic value. Additionally, this review underscores the importance of care setting-ICU, step-down unit, or general ward-and how it influences outcomes. Finally, it highlights critical gaps in research, especially around weaning in non-ICU environments. By consolidating current evidence and identifying predictors and pitfalls, this article aims to support clinicians in making safe, timely, and patient-specific NIV weaning decisions. In the current literature, there are gaps regarding patient selection and lack of universal protocolization for initiation and de-escalation of NIV as the data has been scattered. This review aims to consolidate the relevant information to be utilized by clinicians throughout multiple levels of care in all hospital systems.

Indexed as

acute hypoxic respiratory failurecare settingsHi Flow nasal cannulahypercapnic respiratory failurenoninvasive ventilationpredictorsreintubationweaning from noninvasive ventilation

Identifiers

PMID40725723
PMCPMC12295356

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.