Increased lung volumes, increased alveolar ventilation, V/Q matching improvement and reduction of respiratory muscle work of breathing are the major beneficial effects of noninvasive ventilation (NIV). The advantages of NIV over endotracheal intubation are the avoidance of airway trauma and ventilatory-induced lung injury. Regarding cardiac surgical patients, satisfactory function of both heart and lungs is the main therapeutic target in postoperative period in order to guarantee the oxygen demand/supply balance. Contemporary Cardiothoracic Departments should offer a continuous NIV service which demands proper equipment and a well-trained medical and nursing staff in both ICU and general ward.