Objective To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of early acute respiratory distress syndrome(ARDS) Methods 12 patients with early ARDS were errolled in the study All the patients pulltiled the criteria of ARDS and no improvement after high flow oxygen therapy via mask NIPPV was used because the patients and their family refused intubation Pressure support ventilation (PSV) and positive end expiratory pressure (PEEP) were used via facial mask with Vison or BiPAP ventilator PEEP were set at 8～12 cm H 2 O with 4～6 PSV level Results The baseline respiratory frequency(RR)was (36?4)bpm,PaO 2 was (55?9)mm Hg and oxygen index (OI)was (127?4)mm Hg At final,8 patients survived (S group) and 4 patients died (F group) After 4～6 h treatment with NIPPV,in S group,RR decreased to (32?1 2)bpm ( P