The authors present their experience with the use of bilevel positive airway pressure (BiPAP) administered via a nasal mask to treat respiratory failure in three children following surgery for congenital heart disease. The three children developed progressive atelectasis, hypoxemia, and impending respiratory failure following tracheal extubation in the postoperative period. The use of BiPAP by nasal mask resulted in a decrease in the patients' respiratory rate, an increase in oxygen saturation and PaO2, a decrease in transcutaneous CO2, and resolution of atelectasis. The applications of this technique and the equipment required are reviewed.
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