Noninvasive CPAP

Cure Sleep Apnea Without Cpap

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Non-invasive CPAP was first introduced in the 1980s as a therapy for obstructive sleep apnoea (OS A). This is when a tight-fitting face or nasal mask delivers a single pressure throughout the patient's respiratory cycle. It is therefore not ventilation. In OSA, CPAP prevents pharyngeal collapse. CPAP can also be delivered through an endotracheal tube or tracheostomy tube in spontaneously breathing patients and is usually used this way during weaning. The application of a continuous pressure keeps the alveoli open for longer and improves oxygenation. This is therefore the main indication for CPAP.

The main indications for acute non-invasive CPAP are:

• to deliver increased oxygen in pneumonia or postoperative respiratory failure associated with atelectasis - this should be performed in an ICU;

• acute cardiogenic pulmonary oedema (see below).

CPAP is employed in patients with acute respiratory failure to correct hypoxaemia. In the spontaneously breathing patient, the application of CPAP provides positive end-expiratory pressure (PEEP) that can reverse or prevent atelectasis, improve functional residual capacity, and oxygenation. These improvements may prevent the need for

Safety valve (limits barotrauma)

Humidifier

Three control buttons: On

Three control buttons: On

Safety valve (limits barotrauma)

Tight-fitting mask (nasal, facial or hood)

Humidifier

CPAP valve: 5, 75 or 10 cm H2O (gas flow adjusted to get correct valve movement)

Tight-fitting mask (nasal, facial or hood)

CPAP valve: 5, 75 or 10 cm H2O (gas flow adjusted to get correct valve movement)

Figure 4.5 A CPAP circuit endotracheal intubation. The inspiratory flow in a CPAP circuit needs to high enough to match the patient's peak inspiratory flow rate. If this is not achieved the patient will breathe against a closed valve with the risk that the generation of significant negative intrapleural pressure will lead to the development of pulmonary oedema. Always look at the expiratory valve in patients on CPAP. The valve should always remain slightly open during inspiration (Figure 4.5).

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Sleep Apnea

Sleep Apnea

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