Noninvasive ventilation: Difference between revisions

Revision as of 07:23, 20 May 2011

EMcrit Podcast 19

Authors:

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-CPAP = noninvasive PS
+==Background==
+*CPAP = PEEP = EPAP
-BL-PAP = noninvasive PC (presure ventilation)
+*BiPAP = PEEP + (pressure support = IPAP)
-INDICATION - intact resp drive with more readily reversible etiology
-Possible uses:
-) *COPD
-) OSA
-) Pulm edema
-) PNA
-) Status asthmaticus
-) CHF exacb
-*Consensus statement declares BL-PAP first line for COPD
-BL-PAP SETTINGS
-Initial: IPAP = 8, EPAP = 3 (3-5L/min flow; 100% FiO2)
-Titrate: increase IPAP @ 2cmH2O increments to comfort
--nl pt --> increase EPAP in sync @ 2cmH2O incremnts
--hypercapnic --> increase EPAP in sync @ 1:2.5 ratio
-*keep EPAP <8-10
-/14/06 DONALDSON (adapted from Rosen)
+==Indications==
+#CHF
+#COPD
+#Asthma
+#OSA
+#Pulmonary edema
+#Pneumonia
+==Settings==
+#Failure of oxygenation
+##Pulmonary Edema, PNA
+##Start PEEP 5 (up to 15)
+###Recruits alveoli
+###Improves V/Q mismatch
+###Decreases preload/afterload
+#Failure of ventilation
+##Asthma, COPD
+###When tire out unable to move air
+##Need inspiratory pressure support
+##Start pressure support 5 (up to 15)
+##Consider PEEP 2-3 to overcome the mask
+==Source==
+EMcrit Podcast 19
 [[Category:Pulm]]