Version October 2024
| Absolute |
| The need for emergent intubation (eg, cardiac or respiratory arrest, severe respiratory distress, unstable cardiac arrhythmia) |
| Relative |
| Nonrespiratory organ failure that is acutely life-threatening |
| Severe encephalopathy (eg, GCS <10) |
| Severe upper gastrointestinal bleeding |
| Hemodynamic instability |
| Facial or neurological surgery, trauma, or deformity |
| Significant airway obstruction (eg, laryngeal mass or tracheal tumor) |
| Inability to cooperate, protect airway, or clear secretions (eg, patients at high risk or aspiration) |
| Anticipated prolonged duration of mechanical ventilation (eg, ≥4 to 7 days) |
| Recent esophageal or gastric anastomosis* |
| Multiple contraindications |
| Insufficient staffing support |
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