Pressure Support Compensation for Inspiratory Work due to Endotracheal Tubes and Demand Continuous Positive Airway Pressure

CHEST Journal ◽  
1988 ◽  
Vol 93 (3) ◽  
pp. 499-505 ◽  
Author(s):  
J. Ferdinand Fiastro ◽  
Michael P. Habib ◽  
Stuart F. Quan
Author(s):  
Josep Masip ◽  
Kenneth Planas ◽  
Arantxa Mas

During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure and bilevel pressure support ventilation. Whereas non-invasive pressure support ventilation requires a ventilator, continuous positive airway pressure is a simpler technique that can be easily used in non-equipped areas such as the pre-hospital setting. The success of non-invasive ventilation is related to the adequate timing and selection of patients, as well as the appropriate use of interfaces, the synchrony of patient-ventilator, and the fine-tuning of the ventilator.


PEDIATRICS ◽  
1976 ◽  
Vol 58 (1) ◽  
pp. 118-120
Author(s):  
Bedford W. Bonta ◽  
Joseph B. Warshaw

Since the introduction of continuous positive airway pressure (CPAP) via endotracheal tube by Gregory et al.1 in 1971, several alternate methods of delivering CPAP without the need for endotracheal intubation have been suggested, including the use of nasopharyngeal prongs.2 A major peoblem, however, in delivering CPAP either by endotracheal tube or by nasal prongs has been that of securing the endotracheal tube (or prongs) in place. Recently, Cussel et al.3 have suggested the use of a Hollister plastic clamp adapted for this use. We have used this method successfully for securing endotracheal tubes in place and recently have modified the clamp to secure nasal prongs used to deliver "benign" CPAP without the need for endotracheal intubation in selected patients.


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