CPAP and NPPV Flashcards
(32 cards)
What is CPAP?
A Constant pressure applied to the spontaneously breathing patient.
CPAP is applied via what?
A mask-type device.
CPAP does not do what?
It does not provide volume change or support in the patient’s minute ventilation.
What are some indications for CPAP?
It helps treat obstructive sleep apnea (OSA), it improves oxygenation.
What does NPPV stand for and what does it do?
NPPV stands for: Noninvasive Positive Pressure Ventilation. Pressure is applied intermittently with inspiration having a higher pressure than expiration.
What are the indications for NPPV?
Acute respiratory failure, Chronic respiratory failure
restrictive lung disease, neuromuscular disease, nocturnal hypoventilation
NPPV avoids trauma associated with what?
Intubation, and the complications associated with artificial airways.
What does NPPV reduce the risk of?
VAP, ventilator-associated pneumonia.
What are some contraindications of NIV?
Respiratory arrest (apnea) or the need for immediate intubation,
unable to protect the airway,
excessive secretions, hemodynamic instability, agitated and confused patients,
paradoxical breathing, upper airway obstruction.
What are some advantages of nasal masks?
Less risk of aspiration, enhanced secretion clearance, less claustrophobia, easier speech, and less dead space.
What are some disadvantages of the nasal mask?
Mouth leak,
less effectiveness with nasal obstruction,
nasal irritation and rhinorrhea, and
mouth dryness.
What are some disadvantages of a full face mask?
Increased dead space, difficulty in maintaining a seal, increased risk of pressure sores, claustrophobia, increased aspiration risk, difficulty with speech, inability to eat with the mask on, difficulty with secretion clearance, and possible asphyxiation.
What are the vented masks for?
They require a vent for exhalation and use only one corrugated tube to connect to the ventilator.
What is the typical IPAP setting?
It is typically 8 – 12 cmH2O. It can be adjusted to change the tidal volume.
What is the typical EPAP setting?
It is usually started out at 4 cmH2O and can be increased in order to improve oxygenation.
What does the rise time do?
It determines how fast the vent rises from baseline pressure to target pressure.
The high and low-pressure alarm must be set to what in ST mode?
It should be set at +/- 5 in ST mode.
The low minute ventilation is usually set at what?
10-20% below patient’s baseline.
When will the apnea alarm sound?
When it does not recognize a spontaneous breath.
What are the 9 goals of NIV in the acute care setting?
Improve gas exchange,
avoid intubation,
decrease mortality,
decrease the length of time on the ventilator,
decrease the length of hospital stay,
decrease the chance of ventilator associated pneumonia,
relieve respiratory distress symptoms,
improve patient-ventilator sycnhrony, and
maximize patient comfort.
3 main goals of NPPV:
Avoid of intubation and invasive ventilation
Relieve dyspnea and upper airway obstruction
Enhance the gas exchange
What therapy should be tried first for a patient who has pulmonary edema from left heart failure?
CPAP
Which NIV settings are adequate for a pt with cardiogenic pulmonary edema?
Mask CPAP at 8 – 12 cm H2Ocm and 100% FiO2.
What are some benefits of CPAP in postop abdominal surgery?
It lowers the chances of intubation, pneumonia, and infection/sepsis rates.
