RT Journal Article
SR Electronic
T1 Perioperative Implementation of Noninvasive Positive Airway Pressure Therapies
JF Respiratory Care
FD American Association for Respiratory Care
SP 479
OP 487
DO 10.4187/respcare.05730
VO 63
IS 4
A1 David R Hillman
A1 Carla R Jungquist
A1 Dennis Auckley
YR 2018
UL http://rc.rcjournal.com/content/63/4/479.abstract
AB Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea. An impediment to their use in this setting is a lack of familiarity with their application by hospital clinical staff. This review describes the modes of PAP therapy available, their indications, how therapy is initiated, how efficacy is assessed, common problems encountered with its use, and how these problems can be addressed.