Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP).

Cho, Jae Youn; Lee, Sang Youb; Lee, Sang Hwa; Park, Sang Myun; Suh, Jung Kyung; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho; Yoo, Se Hwa

doi:1995.42.5.723

Tuberc Respir Dis > Volume 42(5); 1995 > Article

Original Article

Tuberculosis and Respiratory Diseases 1995;42(5):723-730.
DOI: https://doi.org/10.4046/trd.1995.42.5.723 Published online October 1, 1995.

Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP).

Jae Youn Cho, Sang Youb Lee, Sang Hwa Lee, Sang Myun Park, Jung Kyung Suh, Jae Jeong Shim, Kwang Ho In, Kyung Ho Kang, Se Hwa Yoo

Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.

Abstract

BACKGROUND
Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation,chronic obstructive pulmonary disease(COPD),and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP).Bi-level positive airway pressure (BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration The device is similar to the positive pressure ventilator or pressure support ventilation. METHOD AND PURPOSE: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. RESULTS: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) PaO2 lhour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01)). PaCO2 lhour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. CONCLUSION: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

Key Words: Intermittent positive pressure ventilation, BiPAP(Bi-level positive airway pressure)