Medical Health Encyclopedia

Continuous positive airflow pressure (CPAP) supplies a steady stream of air through a tube that connects to a from a small bedside machine. The patient wears a plastic mask and the machine applies sufficient air pressure to prevent the tissues from collapsing during sleep. It is not an oxygen-delivery system, but is intended to improve airflow into the lungs. The device is sometimes uncomfortable, and noncompliance rates are high. Studies are mixed on its benefits, suggesting that certain patients, but not others, may be helped by it. More studies are needed. [For detailed information on this device, see Well-Connected Report #65, Sleep Apnea.]

Oxygen Delivery in Emergency Situations

In emergency situations, oxygen may be delivered to the patient in various ways:

Intubation. When standard oxygen therapy does not meet the needs of the patient, endotracheal intubation may be required to deliver high concentrations of oxygen. With intubation, a tube is inserted down through either the nose or the mouth through which oxygen is administered.

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Noninvasive Positive Pressure Ventilation (NPPV). If the patient is able to breathe naturally, oxygen is delivered through a tube using a tightly fitted oxygen mask to maintain airway pressure during breathing. Experts now believe such devices should be first line treatments (in addition to medications) for managing respiratory failure after an acute exacerbation. They allow the patient to communicate and drink fluids and are much better tolerated than nose or throat tubes. They cannot be used on patients with rapidly deteriorating disease, who are uncooperative, or who have facial structures that do not allow the mask to have a tight seal.

Mechanical Ventilation. In very serious cases, such as acute respiratory failure, a mechanical ventilator takes over the function of breathing. The primary goal of ventilation is to eliminate carbon dioxide and restore a balanced exchange of gases with oxygen administration.