Do you mean Asthma or COPD?
In straightforward asthma you would think that CPAP would promote air
trapping, breath stacking and generally make things worse. These folk
usually have lots of auto PEEP on board anyway.(when you ventilate them
anyway).
Perhaps there could be an argument that closing pressure falls in acute
asthma and that by adding PEEP you prevent small airway closure and
therefore alveolar entrappment.
However, I would not wish to try this without some good clinical data to
support it, sounds scary! I take it nobody exploded when you saw it used in
Oz.
I'm intrigued to listen to any other theories.
Simon
Simon Carley
SpR in Emergency Medicine
Manchester Royal Infirmary
England
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Evidence based Emergency Medicine
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----- Original Message -----
From: Paul Redman <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, September 04, 2001 7:10 PM
Subject: Asthma and CPAP
> Quick question - having worked in Australia for a while, I saw a few 'bad'
asthmatics
> avoid the intubation route with the use of CPAP. Having returned and used
it
> sucessfully once here I had (second hand) information that the Repiratory
Physicians
> weren't pleased as it's not in any protocols/guidelines.
>
> Admittedly I cannot find any hard evidence for it's use in Asthma and the
arguments
> about increasing their already high intrathoracic pressure make sense.
>
> Would anyone else use it? Has anyone else seen it used?
>
> Paul Redman
> SpR Mayday Hospital
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