Objective To study the clinical feasibility of invasive mechanical ventilation with bilevel positive airway pressure(BiPAP) non-invasive ventilator in the stable patients needing prolonged mechanical ventilation.Methods Eleven patients with respiratory failure admitted in intensive care unit(ICU)of our department,who needed prolonged mechanical ventilation,between Jun 2004 and Nov 2007 were enrolled in the study and followed until death or Jan 2008.The arterial blood gas analysis data,length of stay(LOS),LOS after changing to BiPAP non-invasive ventilator(Synchrony,Harmony,RESPIRONICS,VPAP III ST-A,RESMED),survival time after discharge(or fulfilled the discharge standards) were reviewed retrospectively.Results The settings of inspiratory pressure,expiratory pressure and respiratory rate of non-invasive ventilation were 21.3 (16-26) cm H2O,4 cm H2O,and 16 min-1,respectively.The LOS (or up to the discharge standard) was (91.5±50.2) days.The LOS (or up to the discharge standard) after changing to BiPAP ventilator was (23.5±12.2) days.The mean survival time after discharge (or up to the discharge standard) was (353.1±296.5) days.Four patients were still alive up to the end of the study.The arterial pH,PaCO2,PaO2,and SaO2 were not significant different before and after changing to BiPAP ventilator.Conclusion The mechanical ventilation with BiPAP non-invasive ventilator via tracheotomy tube is an alternative choice for stable patients needing prolonged mechanical ventilation.