Continuous Positive Pressure Ventilation (CPPV) in the Treatment of Adult Respiratory Distress Syndrom

Abstract

Acute respiratory distress syndrome is characterized by hypoxemia due to increased venous admixture that is attributed mainly to the direct right to left shunting through non-ventilated lung segments. It has been advocated the use of continuous positive pressure ventilation (CPPV) for the treatment of acute respiratory distress. CPPV recruites atelectatic areas for gas exchange, thereby increasing the functional residual capacity (FRC), compliance, oxygen tension and is possibly instrumental in reabsorption of interstitial pulmonary water. This procedure permits to use lower inspired oxygen fraction (FI0₂) in these patients while beeing mechanically ventilated, avoiding oxygen toxicity. Notwithstanding, CPPV may abstruct venous return and so decrease cardiac output and oxygen delivery to the tissues. We present a study on the effects upon gas exchange and clinical evaluation of 75 patients with acute respiratory distress ventilated with CPPV.