Positive pressure mechanical ventilation respiratory failure

Noninvasive positive-pressure ventilation (NPPV) provides ventilatory support with oxygen and pressurized airflow using a face or nasal mask with a tight seal but without endotracheal intubation. In patients with acute respiratory failure due to COPD exacerbations, NPPV was associated with lower mortality, lower intubation rates, shorter hospital stays, and greater improvements in serum pH in 1 hour compared with usual care. Use of NPPV reduces the complications that often arise with invasive mechanical ventilation. NPPV is not appropriate for patients with altered mental status, severe acidosis, respiratory arrest, or cardiovascular instability. 

How should hospitals increase their capacity to provide mechanical ventilation for a surge of patients with acute respiratory failure during a mass casualty event or influenza pandemic Rubinson and colleagues address this issue in a recently published article (Rubinson, Branson, Pesik, Talmor, 2006). Their report is based on an evaluation and assessment of a wide range of positive pressure ventilation (PPV) equipment, with the goal of determining the suitability of each device for mass casualty care. The article provides information useful for determining which types of PPV equipment would be the best choice for hospitals in need of a serviceable alternative to full feature ventilators, which will be in short supply and are too expensive for hospitals to stockpile. 

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