While continuous positive airway pressure (CPAP) is being increasingly employed for many forms of acute respiratory failure and postoperative hypoxaemia, most CPAP systems are either ‘home made’ or incorporated in sophisticated ventilators used in intensive care units. This paper describes the development of a continuous low flow CPAP system using a large latex reservoir bag and venturi generated positive end expiratory pressure (PEEP). The system has been successfully used for over twelve months in the general wards, the intensive care unit, accident and emergency department, the recovery ward and the coronary care unit.
BarachA.L., MartinJ., EckmanM.Positive pressure respiration and its application to the treatment of acute pulmonary edema. Ann Int Med1938; 12: 754–759.
2.
SchmidtG.B., O'NeillW., KotbK.Continuous positive airway pressure in the adult respiratory distress syndrome. Surg Gynecol Obstet1976; 143: 613–619.
3.
VenusB., JacobsH.K., LimL.Treatment of the adult respiratory distress syndrome with continuous positive airway pressure. Chest1979; 76: 257–263.
4.
VaisanenI.T., RasanenJ.Continuous positive airway pressure and supplemental oxygen in the treatment of cardiogenic pulmonary edema. Chest1987; 92: 481–485.
5.
RasanenJ., HeikkilaJ., DownsJ., NikkiP., VaisanenI., ViitanenA.Continuous positive airway pressure by face mask in acute cardiogenic pulmonary edema. Am J Cardiol1985; 55: 296–300.
6.
AlexC.G., AronsonR.M., OnalE., LopataM.Effects of continuous positive airway pressure on upper airway and respiratory muscle activity. J Appl Physiol1987; 62: 2026–2030.
7.
NobleW.H., KayJ.C.Effect of continuous positive-pressure ventilation and oxygenation after pulmonary microemboli in dogs. Crit Care Med1985; 13: 412–415.
8.
LintonD.M., PotgieterP.D.Conservative management of blunt chest trauma. S Afr Med J1982; 64: 917–919.
9.
NaverL., WalterS., GlowinskiJ.Pulmonary fat embolism treated by intermittent continuous positive airway pressure given by face mask. Br Med J1980; 280: 1413–1414.
10.
GlasserK.L., CivettaJ.M., FlorR.J.The use of spontaneous ventilation constant-positive airway pressure in the treatment with salt water near drowning. Chest1975; 67: 355–359.
11.
TaylorG.J., BrennerW., SummerW.R.Severe viral pneumonia in young adults: therapy with continuous positive airway pressure. Chest1976; 69: 722–726.
DeHavenC.B.Jr, HurstJ.M., BransonR.D.Postextubation hypoxemia treated with continuous positive airway pressure mask. Crit Care Med1985; 13: 46–48.
14.
StockM.C., DownsJ.B., GauerP.K., AlsterJ.M., ImreyP.B.Prevention of postoperative pulmonary complications with CPAP, incentive spirometry and conservative therapy. Chest1985; 87: 151–157.
15.
MartinJ.G., ShoreS., EngelL.A.Effect of continuous positive airway pressure on respiratory mechanics and pattern of breathing in induced asthma. Am Rev Respir Dis1982; 126: 812–816.
16.
GibneyR.T.N., WilsonR.S., PontoppidanH.Comparison of work of breathing on high gas flow and demand valve continuous positive airway pressure systems. Chest1982; 83: 692–695.
17.
VialeJ.P., AnnatG., PercivalC., BertrandO., MotinJ.Added inspiratory work of breathing during CPAP ventilation: comparison of two demand-valve devices with a continuous flow-system. Intensive Care Med1986; 12: 374–377.
MoranL.J., JacksonM.P., CameronD.M., PeisachA.R., CunninghamD.N., O'FathartaighM.S.A high flow turbine CPAP system. Intens Care Med1988; 14: 658–660.
20.
BraschiA., LottiG., LocatelliA., BellinzonaG.A continuous flow intermittent mandatory ventilation with continuous positive airway pressure circuit with high-compliance reservoir bag. Crit Care Med1987; 15: 947–950.
21.
GreenbaumD.M., MillenJ.E., ErossB., SnyderJ.V., GrenvikA., SafarP.Continuous positive airway pressure without tracheal intubation in spontaneously breathing patients. Chest1976; 69: 615–620.
22.
CovelliH.D., WeledB.J., BeekmanJ.F.Efficacy of continuous positive airway pressure administered by face mask. Chest1982; 81: 147–150.
23.
CournandA., MotleyL., WerkoL., RichardsD.W.Physiological studies of the effect of intermittent positive pressure breathing on cardiac output in man. Am J Physiol1948; 152: 162–166.
24.
DorinskyP.M., HamilinR.L., GadekJ.E.Alterations in regional blood flow during positive end-expiratory pressure ventilation. Crit Care1987; 15: 106–113.
25.
SteinhoffH.H., KohlhoffR.J., FalkeK.J.Facilitation of renal function by intermittent mandatory ventilation. Intens Care Med1984; 10: 59–65.
26.
ShaM., SaitoY., YokoyamaK., SawaT., AmahaK.Effects of continuous positive-pressure ventilation on hepatic blood flow and intrahepatic oxygen delivery in dogs. Crit Care Med1987; 15: 1040–1043.
27.
HillmanK.M.Pulmonary barotrauma. Current topics in intensive care. Clin Anaesthesiology1985; 3: 877–898.
28.
FroeseA.B., BryanA.C.Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology1974; 41: 242–252.
29.
GattinoniL., PsentiM.L., PelizzolA.The role of total static lung compliance in the management of severe ARDS unresponsible to conventional treatment. Intens Care Med1984; 10: 121–126.
