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CPAP
Continuous Positive Airway Pressure
What is CPAP
• Noninvasive Positive Pressure Ventilation
  (NPPV) is a means to support failing
  respiratory function by ...
• CPAP utilizes low pressure (5 cm H2O) to
  maintain airway patency

• Increases Functional Reserve Capacity (FRC)

• Rec...
Alveoli Splinting

• LaPlace equation - force to increase the size
  of a sphere is greater when the sphere is
  small (th...
Advantages of NPPV
• Avoids potential trauma secondary to
  endotracheal intubation

• Avoids need for sedation

• Allows ...
Disadvantages
• Patient must be alert

• have spontaneous respirations

• tight mask fit (no facial hair)

• feeling of cl...
CPAP vs BiPAP

• Bi level Positive Airway Pressure

• Provides higher inspiratory pressure IPAP

• Increases tidal volume ...
Indications for CPAP
• CHF

• COPD

• Obstructive sleep apnea/Obesity
  Hypovenilation Syndrome

• Immunocompromised patie...
• Cardiac or Respiratory Arrest
      Contraindications
• Hemodynamic or Arrhythmic Instability

• Facial Trauma or deform...
PEEP trial


PEEP   SPO2               HR     BP



 5      84                88    140/84



 10     87                94...
Note: If patient declines into
      respiratory failure,
      remove mask and
      provide mechanical
      ventilation...
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Cpap

  1. 1. CPAP Continuous 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 trial PEEP 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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