On the other hand, NIPPV begun too early might be unhelpful and wasteful of resources if treated patients would have done well without any ventilatory assistance. For this reason, selection guidelines suggest first establishing the need for ventilatory assistance according to clinical and blood gas criteria and exclusion of patients in whom NIPPV is contraindicated or likely to fail. Although a cost benefit analysis would be in favor of NIPPV use in developing countries such as ours, lower initial cost of noninvasive ventilators (compared with standard ventilators), reduced duration of hospitalization and complication rates are likely to translate to favorable economic benefits. Further implication regarding the use of NIPPV need to be addressed in the context of a developing country such as ours.