Riis S
Medisinsk avdeling, Ostfold sentralsykehus, Sarpsborg.
Tidsskr Nor Laegeforen. 1995 Apr 30;115(11):1346-8.
Acute respiratory failure that is unresponsive to medical treatment requires ventilatory support. Non-invasive treatment with a nose or face mask is an alternative to endotracheal intubation in awake and cooperative patients. In patients with acute cardiogenic pulmonary oedema the application of continuous positive airway pressure (CPAP) increases cardiac output. CPAP-treatment is also effective in acute hypercapnic respiratory failure and oxygenation difficulties, but in these conditions pressure or volume-cycled positive pressure ventilation with a mask as an interface often has more to offer. The method reduces the need for endotracheal intubation and hence the time spent by the patient in the intensive care unit, but the need for personnel resources is equal. Possible clinical problems are skin erosions on the bridge of the nose due to pressure from the mask, and systemic hypotension.
对药物治疗无反应的急性呼吸衰竭需要通气支持。对于清醒且配合的患者，使用鼻罩或面罩进行无创治疗是气管插管的替代方法。在急性心源性肺水肿患者中，应用持续气道正压通气（CPAP）可增加心输出量。CPAP治疗对急性高碳酸血症性呼吸衰竭和氧合困难也有效，但在这些情况下，以面罩作为界面的压力或容量控制的正压通气通常更具优势。该方法减少了气管插管的需求，从而缩短了患者在重症监护病房的停留时间，但所需的人力资源相当。可能出现的临床问题包括因面罩压力导致的鼻梁皮肤糜烂和全身性低血压。
