Page 227 - Clinical Application of Mechanical Ventilation

Noninvasive Positive Pressure Ventilation 193

Key Terms

apnea index inspiratory positive airway pressure
apnea-hypopnea index (IPAP)
bilevel positive airway pressure nasal mask
(bilevel PAP) nasal pillows

continuous positive airway pressure noninvasive positive pressure
(CPAP) ventilation (NPPV)
desaturation index obstructive sleep apnea (OSA)
expiratory positive airway pressure oronasal mask
(EPAP) positive end-expiratory pressure
full-face mask (PEEP)
hypopnea

Learning Objectives

After studying this chapter and completing the review questions, the learner
should be able to:
List the physiologic effects of NPPV.
Describe the clinical application of continuous positive airway pressure
(CPAP).
Outline the signs of obstructive sleep apnea and its management.
Discuss the use of Bilevel Positive Airway Pressure (bilevel PAP).
Describe the characteristics of the common interfaces for CPAP and
bilevel PAP.
List the clinical application and potential problems with nasal mask, oronasal
mask, nasal pillows, and full-face mask.
Describe the procedure to set up and implement CPAP and bilevel PAP.

INTRODUCTION

Noninvasive positive pressure ventilation (NPPV) is a technique of
noninvasive positive pressure
ventilation (NPPV): NPPV pro- providing ventilation without the use of an artificial airway. It has been used success-
vides assisted ventilation without fully in the management of airflow obstruction in sleep apnea (Guilleminault, et al.
an artificial airway.
1998) and in the reduction of respiratory workload in gross obesity (Pankow et al.,
1997). More recently NPPV has been used in the management of acute respira-
tory failure. In selected patients with acute ventilatory failure, NPPV is as effective
as conventional mechanical ventilation in improving gas exchange (Abou-Shala &
Meduri, 1996). Since an artificial airway is not required in the use of NPPV, fewer

Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.