critical care medicine
How To Do Noninvasive Positive Pressure Ventilation
Introduction
Noninvasive positive pressure ventilation (NPPV) is ventilatory assistance without an invasive artificial airway. It is delivered to a spontaneously breathing patient via a tight-fitting mask that covers the nose or both the nose and mouth. Because the airway is unprotected, aspiration is possible, so patients must have adequate alertness and airway-protective reflexes. (See also Overview of Mechanical Ventilation .) NPPV can be given as Continuous positive airway pressure (CPAP) Bilevel positive airway pressure (BPAP), which is triggered by the patient’s respirations With CPAP, constant pressure is maintained throughout the respiratory cycle with no additional inspiratory support. When using BPAP, the physician sets both the expiratory positive airway pressure (EPAP, which is the physiologic equivalent of CPAP and positive end-expiratory pressure [PEEP]) and, additionally, the inspiratory positive airway pressure (IPAP). 