Which condition is a contraindication for the use of noninvasive positive pressure ventilation?

Noninvasive positive pressure ventilation (NIPPV) is primarily used to support patients with respiratory distress without the need for intubation. However, certain conditions can make its use inadvisable. Severe hypoxemia represents a state where the blood oxygen levels are critically low. In this scenario, patients often require immediate and effective interventions to improve oxygenation, such as invasive mechanical ventilation, which provides more reliable oxygenation and ventilation than noninvasive methods.

In cases of severe hypoxemia, the risks associated with noninvasive ventilation, such as inadequate oxygen delivery and exacerbation of respiratory failure, could lead to worse outcomes. The inability of NIPPV to adequately address severe hypoxemia necessitates more aggressive management, typically through invasive ventilation.

The other conditions listed, such as controlled asthma, mild pneumonia, and stable hypertension, generally do not preclude the use of NIPPV as they can often be managed effectively with this supportive measure when appropriate criteria are met. Noninvasive positive pressure ventilation can be beneficial for asthma and pneumonia when patients demonstrate adequate respiratory effort and do not exhibit severe gas exchange abnormalities.