Continuous positive pressure breathing without and with inspiratory pressure support in acute respiratory failure when mean airway pressure is constant

1991 ◽  
Vol 17 (8) ◽  
pp. 461-464
Author(s):  
H. Langenstein
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Airway Pressure ◽  
Pressure Support ◽  
Inspiratory Pressure ◽  
Positive Pressure ◽  
Mean Airway Pressure ◽  
Inspiratory Pressure Support ◽  
Continuous Positive Pressure

Management of Acute Respiratory Failure Due to Pulmonary Edema With Nasal Positive Pressure Support

CHEST Journal ◽  
1994 ◽  
Vol 105 (1) ◽  
pp. 229-231 ◽  
Author(s):  
Stephen E. Lapinsky ◽  
David B. Mount ◽  
Dale Mackey ◽  
Ronald F. Grossman
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pulmonary Edema ◽  
Pressure Support ◽  
Positive Pressure

Continuous Positive-Pressure Ventilation in Acute Respiratory Failure

1970 ◽  
Vol 283 (26) ◽  
pp. 1430-1436 ◽  
Author(s):  
Anil Kumar ◽  
Konrad J. Falke ◽  
Bennie Geffin ◽  
Carolyn F. Aldredge ◽  
Myron B. Laver ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Continuous Positive Pressure

CONTINUOUS POSITIVE-PRESSURE VENTILATION IN ACUTE RESPIRATORY FAILURE

1972 ◽  
Vol 16 (2) ◽  
pp. 103???104
Author(s):  
A. Kumar ◽  
K. J. Falke ◽  
B. Geffin ◽  
C. F. Aldredge ◽  
M. B. Laver ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Continuous Positive Pressure

From Continuous Positive-pressure Breathing to Ventilator-induced Lung Injury

2004 ◽  
Vol 101 (4) ◽  
pp. 1015-1017 ◽  
Author(s):  
Henning Pontoppidan ◽  
Srinivasa N. Raja
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Arterial Oxygen Tension ◽  
Intermittent Positive Pressure Ventilation ◽  
Arterial Oxygen ◽  
Positive Pressure ◽  
Residual Capacity ◽  
The Mean ◽  
Continuous Positive Pressure

Continuous positive-pressure ventilation in acute respiratory failure. By Kumar A, Falke KJ, Geffin B, Aldredge CF, Laver MB, Lowentein E, Pontoppidan H. N Engl J Med 1970; 283:1430-6. Reprinted with permission. Continuous positive-pressure ventilation was used in eight patients with severe acute respiratory failure. Cardiac output and lung function were studied during continuous positive-pressure ventilation (mean end-expiratory pressure, 13 cm H2O) and a 30-min interval of intermittent positive-pressure ventilation. Although the mean cardiac index increased from 3.6 to 4.5 l/min per square meter of body surface area, the mean intrapulmonary shunt increased by 9% with changeover to intermittent positive-pressure ventilation. Satisfactory oxygenation was maintained in all patients during continuous positive-pressure ventilation with 50% inspired oxygen or less. With intermittent positive-pressure ventilation, arterial oxygen tension promptly fell by 161 mm of mercury, 79% occurring within 1 min. Prevention of air-space collapse during expiration and an increase in functional residual capacity probably explain improved oxygenation with continuous positive-pressure ventilation. In four patients, subcutaneous emphysema or pneumothorax developed. Weighed against the effects of prolonged hypoxemia, these complications were not severe enough to warrant cessation of continuous positive-pressure ventilation.

Respiratory response to inhaled CO2 during positive inspiratory pressure in humans

1994 ◽  
Vol 77 (2) ◽  
pp. 876-882 ◽  
Author(s):  
P. Scheid ◽  
F. Lofaso ◽  
D. Isabey ◽  
A. Harf
Keyword(s):  
Airway Pressure ◽  
Pressure Support ◽  
Normal Subjects ◽  
Inspiratory Pressure ◽  
Respiratory Drive ◽  
Respiratory Response ◽  
Co2 Sensitivity ◽  
Inspiratory Pressure Support ◽  
Low Levels ◽  
End Tidal

To investigate ventilatory CO2 sensitivity during inspiratory pressure support (IPS), we administered inspiratory CO2 [fractional concn (FICO2) 0.01, 0.03, or 0.05] in eight normal subjects without (CTRL) or with (Pinsp) positive inspiratory airway pressure (5 or 10 cmH2O). At CTRL and low IPS, CO2 inhalation led to a significant increase in tidal volume (VT) with nearly identical slopes in the plot of VT vs. end-tidal PCO2. At the high IPS level, VT at FICO2 of 0 was significantly above the value at lower Pinsp and did not increase with CO2 unless FICO2 was elevated to > 0.03. There was very little effect of either Pinsp or FICO2 on respiratory frequency and respiratory timing. The data suggest that the CO2 sensitivity of ventilation is similar at low levels of IPS as during CTRL. However, at high levels of IPS, VT is determined largely by the passive inflation and, thus, independent of CO2. CO2 has to be elevated to increase the respiratory drive before VT becomes CO2 sensitive.

scholarly journals Evaluation of a Humidified Nasal High-Flow Oxygen System, Using Oxygraphy, Capnography and Measurement of Upper Airway Pressures

2011 ◽  
Vol 39 (6) ◽  
pp. 1103-1110 ◽  
Author(s):  
J. E. Ritchie ◽  
A. B. Williams ◽  
C. Gerard ◽  
H. Hockey
Keyword(s):  
Healthy Volunteers ◽  
Airway Pressure ◽  
Gas Flow ◽  
Air Entrainment ◽  
High Flow ◽  
Positive Pressure ◽  
Mean Airway Pressure ◽  
Flow Rates ◽  
Oxygen Fraction ◽  
Airway Pressures

In this study, we evaluated the performance of a humidified nasal high-flow system (Optiflow™, Fisher and Paykel Healthcare) by measuring delivered FiO2 and airway pressures. Oxygraphy, capnography and measurement of airway pressures were performed through a hypopharyngeal catheter in healthy volunteers receiving Optiflow™ humidified nasal high flow therapy at rest and with exercise. The study was conducted in a non-clinical experimental setting. Ten healthy volunteers completed the study after giving informed written consent. Participants received a delivered oxygen fraction of 0.60 with gas flow rates of 10, 20, 30, 40 and 50 l/minute in random order. FiO2, FEO2, FECO2 and airway pressures were measured. Calculation of FiO2 from FEO2 and FECO2 was later performed. Calculated FiO2 approached 0.60 as gas flow rates increased above 30 l/minute during nose breathing at rest. High peak inspiratory flow rates with exercise were associated with increased air entrainment. Hypopharyngeal pressure increased with increasing delivered gas flow rate. At 50 l/minute the system delivered a mean airway pressure of up to 7.1 cmH2O. We believe that the high gas flow rates delivered by this system enable an accurate inspired oxygen fraction to be delivered. The positive mean airway pressure created by the high flow increases the efficacy of this system and may serve as a bridge to formal positive pressure systems.

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