During patient assessment, what sign may indicate a complication in a patient receiving NIPPV?

Abdominal distension can be a significant indicator of complications in patients undergoing non-invasive positive pressure ventilation (NIPPV). This sign may suggest several underlying issues, such as excessive air swallowing (aerophagia), which can occur due to high airway pressures or inadequate mask fit. Abdominal distension can also indicate decreased respiratory efficiency and potential diaphragm displacement due to increased intra-abdominal pressure, which can complicate breathing mechanics further and lead to inadequate ventilation.

In contrast, improved tolerance to biphasic air pressure typically reflects a positive response to treatment, indicating that the patient is adjusting well to the ventilatory support. Increased heart rate during treatment might occur due to anxiety or discomfort but is not necessarily a definitive sign of a complication. Stable oxygen saturation levels suggest that the patient is adequately oxygenated on NIPPV, which is typically a favorable outcome. Therefore, the presence of new onset abdominal distension serves as an important clinical sign requiring further investigation for potential complications.