Editorials Noninvasive Ventilation Failure: The Answer Is Blowing in the Leaks

Noninvasive ventilation (NIV) is expected to become more and more common in the treatment of acute respi-ratory failure,1 as new fields of application are explored, and evidence of its efficacy is growing. Moreover, NIV avoids some of the complications related to mechanical ventilation and, in particular, to tracheal intubation.2 However, there is also an increasing awareness of the complexity of NIV treatment. Success depends on multi-ple factors not under the control of the clinical staff, such as the cause and severity of the acute respiratory failure and the patient’s comorbidities. But success is also strongly influenced by the experience and skill of the healthcare personnel: the choice of the right timing (early!),1 the choice of the right ventilator,3 and the choice of the right venti-lation settings. Above all, in our opinion, is the choice o