Carbon Dioxide Rebreathing During Pressure Support Ventilation with Airway Management System (BiPAP) Devices
In the 1980s, the development of noninvasive ventilation using pressure support ventilation with or without positive end-expiratory pressure (PEEP) constituted a major improvement in the management of both acute and chronic respiratory failure. Meanwhile, the first bilevel ventilator was designed (BiPAP; Respironics; Murrysville, PA). Initially intended to improve home treatment of sleep apnea syndrome, this device lacked alarms and monitoring systems but was easy to handle and low priced. It was a nasal continuous positive airway pressure device equi Carbon Dioxide Rebreathing During Pressure Support Ventilation with Airway Management System (BiPAP) DevicesF. Lofaso and H. Prigentpped with a solenoid magnetic valve system allowing separation of PEEP (with a minimal level below 2 cmH2O [1, 2]) and inspiratory positive airway pressure adjustments. Like other nasal continuous positive airway pressure devices designed for home, it used a single-limb circuit with a leak port (i.e., Respironics Whisper Swivel). Therefore, there was a risk of CO2 rebreathing, which was initially considered an important limitation for extending its use in the treatment of respiratory failure, especially hypercapnic respiratory failure, which was considered to have the best outcome with noninvasive ventilation.
KeywordsPressure Support Ventilation Nasal Continuous Positive Airway Pressure Noninvasive Ventilation Peep Level Chronic Respiratory Failure
- 7.Louis B, Leroux K, Isabey D et al (2010) Effect of manufacturer-inserted mask leaks on ventilator performance. Eur Respir J 35:627–636Google Scholar