Continuous positive airway pressure

Continuous positive airway pressure (CPAP) is the addition of positive pressure to the expiratory side of the breathing circuit of a spontaneously ventilating patient who may or may not be intubated. This sets the baseline upper airway pressure above atmospheric pressure, prevents alveolar collapse and possibly recruits already collapsed alveoli. It is usually administered in increments of 2.5cmH2O to a maximum of 10cmH2O and applied via either a tight-fitting face mask (face CPAP), nasal mask (nasal CPAP) or expiratory limb of a 'T' piece breathing circuit. A high flow (i.e. above peak inspiratory flow) inspired air-oxygen supply, or a large reservoir bag in the inspiratory circuit, is necessary to keep the valve open. CPAP improves oxygenation and may reduce the work of breathing by reducing the alveolar-to-mouth pressure gradient in patients with high levels of intrinsic PEEP. Transient periods of high CPAP (e.g. 40cm H2O for 40s) may be a useful manoeuvre for recruiting collapsed alveoli and improving oxygenation in ARDS.

Sleep Apnea

Sleep Apnea

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