This module is the fourth of the series and covers the use of noninvasive mechanical ventilation and Average Volume Assured Pressure Support or AVAPS to reduce work of breathing in patients with respiratory failure. The common disorders that affect patients who are appropriate for this therapy and the goals of therapy, along with detailed equipment settings and titration protocols, are provided. The benefits of therapy and adjustments to therapy related to comfort and disease progression are outlined. A case study that includes a demonstration of the changes in breathing pattern throughout the titration and rationale for the final settings is included so that students gain an understanding of how to appropriately apply this therapy.