Cpap
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Cpap

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Cpap Cpap Presentation Transcript

  • CPAPContinuous Positive Airway Pressure
  • What is CPAP• Noninvasive Positive Pressure Ventilation (NPPV) is a means to support failing respiratory function by delivering oxygen enriched gas under pressure without requiring endotracheal intubation• Best used as a short term strategy to "buy time" for medical therapy to treat rapidly reversible causes of respiratory failure
  • • CPAP utilizes low pressure (5 cm H2O) to maintain airway patency• Increases Functional Reserve Capacity (FRC)• Recruit Alveoli• Increase Oxygenation• Decrease work of breathing• Alveoli splinting
  • Alveoli Splinting• LaPlace equation - force to increase the size of a sphere is greater when the sphere is small (think of blowing up a balloon)• Increased surface area improves oxygen diffusion through alveolar/capillary membrane
  • Advantages of NPPV• Avoids potential trauma secondary to endotracheal intubation• Avoids need for sedation• Allows patient to maintain ability to communicate• Avoids risk of ventilator associated pneumonia
  • Disadvantages• Patient must be alert• have spontaneous respirations• tight mask fit (no facial hair)• feeling of claustrophobia• Increased Thoracic Pressure (ITP) can reduce Cardiac Output (CO)
  • CPAP vs BiPAP• Bi level Positive Airway Pressure• Provides higher inspiratory pressure IPAP• Increases tidal volume and ventilation• Assists with removal of CO2
  • Indications for CPAP• CHF• COPD• Obstructive sleep apnea/Obesity Hypovenilation Syndrome• Immunocompromised patients• facilitated ventilator weaning• Neuromuscular disease
  • • Cardiac or Respiratory Arrest Contraindications• Hemodynamic or Arrhythmic Instability• Facial Trauma or deformity• Severe upper GI bleed• Severe encephalopathy• Inability to cooperate and/or protect airway• Inability to clear secretions• Upper airway obstruction
  • PEEP trialPEEP SPO2 HR BP 5 84 88 140/84 10 87 94 130/70 15 89 98 120/84 20 95 115 80/44
  • Note: If patient declines into respiratory failure, remove mask and provide mechanical ventilation with BVM