Nasal CPAP for severe hypoxia

Noninvasive positive-pressure ventilation in patients with acute respiratory failure

This article provides a systematic review of the literature on the application of noninvasive ventilation in various forms of hypercapnic and hypoxemic respiratory failures. A description of the underlying pathophysiology is followed by a review of physiologic data explaining the mechanisms of action of noninvasive ventilation. A critical review of clinical studies is presented with specific suggestions. The methodology of correctly implementing and monitoring noninvasive ventilation in patients with acute respiratory failure, critical to success, is detailed.

Pressure support ventilation with a simplified ventilatory support system administered with a nasal mask in patients with respiratory failure

Thirty-one consecutive patients with respiratory failure in whom treatment with intubation and mechanical ventilation was being strongly considered received alternative ventilatory support by means of a BiPAP ventilatory support system and nasal mask. Laboratory measurements and physical findings were documented before and 1 h after initiation of support. This support improved patient comfort, slowed respiratory rate, and improved oxygenation. Support lasted from 2 h to six days. Seventy-six percent (22/29) of patients recovered from this episode of respiratory failure, avoiding alternative mechanical ventilatory support. There were no complications associated with aspiration, gastric distention, or acute separation from support.