Critical Care Focus in Non-Invasive Ventilatory Approaches: a Loop Approaches

Non-invasive ventilation has become a cornerstone in managing respiratory failure in critical care and perioperative settings. However, its application in high-risk populations—such as elderly patients and those with hypercapnic respiratory failure—remains underexplored and inconsistently applied. The perioperative period presents unique physiological challenges that necessitate tailored NIV strategies to prevent respiratory decompensation, reduce reintubation rates, and enhance recovery. This Research Topic seeks to consolidate current knowledge, address clinical uncertainties, and promote a standardized, evidence-based loop approach to NIV from preoperative optimization through postoperative care.

The primary goal of this Research Topic is to synthesize cutting-edge research and clinical insights into the use of non-invasive ventilatory approaches in high-risk anesthesiology, with a focus on hypercapnic and elderly patients. We aim to address the following key questions: How can NIV be optimally integrated into perioperative pathways? What are the best practices for patient selection, timing, and mode selection? How do we manage transitions between care phases to ensure continuity and safety? By bringing together multidisciplinary perspectives—from anesthesiology, critical care, geriatrics, and respiratory therapy—we hope to develop practical guidelines, identify research priorities, and foster innovation in ventilatory care. Ultimately, this collection will serve as a comprehensive resource for clinicians and researchers dedicated to improving outcomes in vulnerable surgical populations.

We welcome original research, review articles, case reports, and perspective pieces that address non-invasive ventilatory strategies in perioperative and critical care contexts. Topics of interest include but are not limited to:

- Preoperative respiratory optimization using NIV

- Intraoperative NIV applications in high-risk surgery

- Postoperative NIV protocols to prevent respiratory failure

- NIV in elderly and frail surgical patients

- Management of hypercapnic respiratory failure in the perioperative setting

- Technological advances and monitoring in NIV

- Multidisciplinary care models and care continuity

- Education, training, and implementation strategies



Manuscripts should be clinically relevant, evidence-based, and contribute to the advancement of perioperative respiratory care.