The Value of Positive Pressure Ventilations for Clients in Acute Respiratory Distress as a Result of Cardiac and Pulmonary Issues

Patrick O’Connell

Adelphi University, Garden City, USA.

DOI: 10.4236/ojrd.2015.52005                

Abstract

Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chronic obstructive pulmonary disease (COPD) and asthma. Limitations to successful NIV and CPAP therapy were evaluated to determine how prolonged initiation of treatment may lead to hypoxemia (decreased oxygen in the blood) and hypercapnia (increased carbon dioxide in the blood) resulting in poor outcomes. Method: Reviews of literature from nursing and allied health data bases (CINAHL and ProQuest) with terms pulmonary edema, positive pressure device and non-invasive ventilation from 2010 to 2014 were used. Studies were conducted in the hospital and prehospital settings. Results: The literature search located 7 articles from CINAHL and 25 articles from ProQuest. A total of 6 of these articles were analyzed. Additional sources of data were obtained from Ignatavicius and Workman (2013) Medical-Surgical Nursing Patient-Centered Collaborative Care 7th edition and American Journal of Nursing (02/2013) Volume 113: 2. Conclusion: All of the articles concluded that early initiation of continuous positive airway pressure ventilations in the short-term was beneficial; however, late initiation of therapy required additional interventions. The studies indicated that early use of positive airway pressure in acute respiratory distress improved breath rate, heart rate and blood pressure. The use of positive airway pressure for respiratory distress may decrease the need for endotracheal intubation.

Keywords

Continuous Positive Airway Pressure, Non-Invasive Ventilation, Acute Pulmonary Edema, Asthma, Chronic Obstructive Pulmonary Disease, Prehospital, Hospital

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	ARDS Foundation (2010) Facts about ARDS, ARDS Foundation. www.ardsil.com/facts.htm
[2]	Burt, L. and Corbridge, S. (2013) COPD Exacerbations. American Journal of Nursing, 113, 34-44.
[3]	Ignatavicius, D. and Workman, L. (2013) Medical-Surgical Nursing: Patient-Centered Collaborative Care. 7th Edition, Elsevier Inc., St. Louis.
[4]	Nava, S. (2013) Behind a Mask: Tricks, Pitfalls, and Prejudices for Noninvasive Ventilation. Respiratory Care, 58, 1367-1376.
[5]	Williams, B., Boyle, M., Robertson, N. and Giddings, C. (2012) When Pressure Is Positive: A Literature Review of the Prehospital Use of Continuous Positive Airway Pressure. Prehospital and Disaster Medicine, 28, 52-60.
[6]	Bledsoe, B., Anderson, E., Hodnick, R., Johnson, L., Johnson, S. and Dievendorf, E. (2012) Low-Fractional Oxygen Concentration Continuous Positive Airway Pressure Is Effective in the Prehospital Setting. Prehospital Emergency Care, 16, 217-221.
[7]	Weng, C., Zhao, Y., Liu, Q., Fu, C., Sun, F., Ma, Y. and He, Q. (2010) Meta-Analysis: Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema. Annals of Internal Medicine, 152, 590-600. http://dx.doi.org/10.7326/0003-4819-152-9-201005040-00009
[8]	Keenan, S., Sinuff, T., Burns, K., Muscedere, J., Kutsogiannis, J., Mehta, S., Dodek, P., et al. (2011) Clinical Practice Guidelines for the Use of Noninvasive Positive-Pressure Ventilation and Noninvasive Continuous Positive Airway Pressure in the Acute Care Setting. Canadian Medical Association Journal (CMAJ), 183, E195-E214. http://dx.doi.org/10.1503/cmaj.100071
[9]	Khalid, I., Sherbini, N., Qushmaq, I., Qubajah, M., Nisar, A., Khalid, T. and Hamad, W. (2014) Outcomes of Patients Treated with Noninvasive Ventilation by a Medical Emergency Team on the Wards. Respiratory Care, 59, 186-192. http://dx.doi.org/10.4187/respcare.02515
[10]	Dib, J., Martin, S. and Luckert, A. (2012) Prehospital Use of Continuous Positive Airway Pressure for Acute Severe Congestive Heart Failure. Journal of Emergency Medicine, EMJ, 42, 553-558. http://dx.doi.org/10.1016/j.jemermed.2011.06.002