Non-invasive Ventilation - CPAP

Question 1

What is CPAP?

Answer 1

CPAP is a form of non-invasive ventilation used in spontaneously breathing patients. CPAP reduces the work of breathing, improves pulmonary gas exchange & is associated with decreased intubation rates & hospital length of stay.

When CPAP is administered to patients with cardiogenic APO, the increased intrathoracic pressure leads to reduced venous return (preload), reduced afterload & improved cardiac function.

Question 2

What are the indications for CPAP?

Answer 2

1. Acute pulmonary oedema

Question 3

What are the contraindications for CPAP?

Answer 3

1. Patients under 16 years
2. GCS 8 or less
3. Inadequate ventilatory drive
4. Hypotension (SBP <90)
5. Pneumothorax
6. Facial trauma
7. Epistaxis

Question 4

What are the possible complications of CPAP?

Answer 4

1. Aspiration
2. Gastric distension
3. Hypotension
4. Corneal drying
5. Barotrauma

Question 5

What is the procedure for CPAP?

Answer 5

1. Place the patient in a seated position
2. Explain the procedure
3. Prepare equipment
4. Select appropriate size (red/size 4 for small adults or blue/size 5 for large adults)
5. Attach tubing etc and adjust the O2 flow rate to 8 or 10L/ min
6. Monitor patient’s response to treatment
7. Increase flow rate ever 3-5 min to increase airway pressure
   (8, 10, 12 or 15 L/min)