ARDS에서 아주 제한적으로 NIPPV를 사용할 수 있다고는 합니다.. 하지만 아직까지 ARDS에서 NIPPV를 사용해도 될지에 대한 대규모 연구결과가 없어서 대부분은 MV 해서 low tidal volume ventilation을 한다고 하네요

Most clinicians use invasive mechanical ventilation (ie, ventilation via an endotracheal tube or tracheostomy with breaths delivered by a mechanical ventilator) for patients with ARDS, particularly those with moderate or severe ARDS (ie, arterial oxygen tension/fraction of inspired oxygen [PaO₂/FiO₂] ≤200 mmHg on positive end-expiratory pressure ≥5 cm H₂O). Noninvasive ventilation (NIV; ie, ventilation via a mask, nasal prongs, or helmet with breaths delivered by an NIV device) may be reserved for the occasional patient with mild ARDS who is hemodynamically stable, is easily oxygenated, does not need immediate intubation, and has no contraindications to its use. (Uptodate - ARDS ventilator managment strategies for adults)