Cpap

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Cpap

  1. 1. CPAPContinuous Positive Airway Pressure
  2. 2. 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
  3. 3. • 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
  4. 4. 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
  5. 5. 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
  6. 6. 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)
  7. 7. CPAP vs BiPAP• Bi level Positive Airway Pressure• Provides higher inspiratory pressure IPAP• Increases tidal volume and ventilation• Assists with removal of CO2
  8. 8. Indications for CPAP• CHF• COPD• Obstructive sleep apnea/Obesity Hypovenilation Syndrome• Immunocompromised patients• facilitated ventilator weaning• Neuromuscular disease
  9. 9. • 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
  10. 10. 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
  11. 11. Note: If patient declines into respiratory failure, remove mask and provide mechanical ventilation with BVM

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