CPAP
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CPAP
Continuous positive airway pressure (CPAP) is a form of positive airway pressure (PAP) ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person. The application of positive pressure may be intended to prevent upper airway collapse, as occurs in obstructive sleep apnea, or to reduce the work of breathing in conditions such as acute decompensated heart failure. CPAP therapy is highly effective for managing obstructive sleep apnea. Compliance and acceptance of use of CPAP therapy can be a limiting factor, with 8% of people stopping use after the first night and 50% within the first year. Medical uses Severe to moderate obstructive sleep apnea CPAP is the most effective treatment for moderate to severe obstructive sleep apnea, in which the mild pressure from the CPAP prevents the airway from collapsing or becoming blocked. CPAP has been shown to be 100% effective at eliminating obstru ...
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Positive Airway Pressure
Positive airway pressure (PAP) is a mode of respiratory ventilation used in the treatment of sleep apnea. PAP ventilation is also commonly used for those who are critically ill in hospital with respiratory failure, in newborn infants (neonates), and for the prevention and treatment of atelectasis in patients with difficulty taking deep breaths. In these patients, PAP ventilation can prevent the need for tracheal intubation, or allow earlier extubation. Sometimes patients with neuromuscular diseases use this variety of ventilation as well. CPAP is an acronym for "continuous positive airway pressure", which was developed by Dr. George Gregory and colleagues in the neonatal intensive care unit at the University of California, San Francisco. A variation of the PAP system was developed by Professor Colin Sullivan at Royal Prince Alfred Hospital in Sydney, Australia, in 1981. The main difference between BiPAP and CPAP machines is that BiPAP machines have two pressure settings: the pr ...
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Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep. These episodes are termed "apneas" with complete or near-complete cessation of breathing, or "hypopneas" when the reduction in breathing is partial. In either case, a fall in blood oxygen saturation, a disruption in sleep, or both may result. A high frequency of apneas or hypopneas during sleep may interfere with restorative sleep, whichin combination with disturbances in blood oxygenationis thought to contribute to negative consequences to health and quality of life. The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime (e.g. excessive daytime sleepiness, decreased cognitive function). Most individuals with OSA are un ...
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Mandibular Advancement Splint
A mandibular splint or mandibular advancement splint is a prescription custom-made medical device worn in the mouth used to treat sleep-related breathing disorders including: obstructive sleep apnea (OSA), snoring, and TMJ disorders. These devices are also known as mandibular advancement devices, sleep apnea oral appliances, oral airway dilators, and sleep apnea mouth guards. The American Academy of Sleep Medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) recommend that sleep physicians should prescribe sleep apnea oral appliances for the adult patients who need treatment for their primary snoring (without obstructive sleep apnea) rather than no treatment and for the patients who have obstructive sleep apnea but are intolerant to the CPAP therapy, or for those who prefer alternate therapy. Vanderveken ''et al'' (2008) researched prescription custom-made splints head-to-head with thermoplastic over-the-counter splints: "Our results suggest that the thermop ...
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Modes Of Mechanical Ventilation
Modes of mechanical ventilation are one of the most important aspects of the usage of mechanical ventilation. The mode refers to the method of inspiratory support. In general, mode selection is based on clinician familiarity and institutional preferences, since there is a paucity of evidence indicating that the mode affects clinical outcome. The most frequently used forms of volume-limited mechanical ventilation are intermittent mandatory ventilation (IMV) and continuous mandatory ventilation (CMV). There have been substantial changes in the nomenclature of mechanical ventilation over the years, but more recently it has become standardized by many respirology and pulmonology groups. Writing a mode is most proper in all capital letters with a dash between the control variable and the strategy (i.e. PC-IMV, or VC-MMV etc.). Taxonomy for mechanical ventilation The taxonomy is a logical classification system based on 10 maxims of ventilator design 10 maxims #A breath is one cyc ...
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Infant Respiratory Distress Syndrome
Infantile respiratory distress syndrome (IRDS), also called respiratory distress syndrome of newborn, or increasingly surfactant deficiency disorder (SDD), and previously called hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of pulmonary surfactant production and structural immaturity in the lungs. It can also be a consequence of neonatal infection and can result from a genetic problem with the production of surfactant-associated proteins. IRDS affects about 1% of newborns and is the leading cause of death in preterm infants. Data has shown the choice of elective caesarean sections to strikingly increase the incidence of respiratory distress in term infants; dating back to 1995, the UK first documented 2,000 annual caesarean section births requiring neonatal admission for respiratory distress. The incidence decreases with advancing gestational age, from about 50% in babies born at 26–28 weeks to about 25% at 30–31 weeks ...
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Colin Sullivan (physician)
Colin Sullivan is an Australian physician, professor, and inventor known for his invention of the nasal Continuous Positive Airway Pressure (CPAP) circuit, made of continuous flow machine and vented nasal mask, in June 1980. Sullivan’s development of the nasal CPAP was a product of his long-term interest in the upper respiratory airway and its role in SIDS (aka crib death or cot death). Prior to the invention of the nasal CPAP machine sleep apnea was often treated with radical measures such as tracheotomy. In 2009 Prof. Sullivan was awarded an Officer of the Order of Australia The Order of Australia is an honour that recognises Australian citizens and other persons for outstanding achievement and service. It was established on 14 February 1975 by Elizabeth II, Queen of Australia, on the advice of the Australian Gove ... Award for "service to medicine as an innovator in the field of sleep disorders and the development of equipment and treatment practices". References ...
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Royal Prince Alfred Hospital
The Royal Prince Alfred Hospital (abbreviated RPAH or RPA) is a major public teaching hospital in Sydney, Australia, located on Missenden Road in Camperdown. It is a teaching hospital of the Central Clinical School of the Sydney Medical School at the University of Sydney and is situated in proximity to the Blackburn Building of the university's main campus. RPAH is the largest hospital in the Sydney Local Health District, with approximately 700 beds (circa 2005). Following a $350 million redevelopment, the perinatal hospital King George V Memorial Hospital has been incorporated into it. An Australian television documentary, '' RPA'', was filmed there from 1995 to 2012, depicting the everyday workings of a major metropolitan hospital. History Royal Prince Alfred is one of the oldest hospitals in NSW. The funds were raised by public subscription, to make a monument to commemorate the recovery of Prince Alfred, Duke of Edinburgh from an assassination attempt in 1868 by Henr ...
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Positive End-expiratory Pressure
Positive end-expiratory pressure (PEEP) is the pressure in the lungs (alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration. The two types of PEEP are extrinsic PEEP (PEEP applied by a ventilator) and intrinsic PEEP (PEEP caused by an incomplete exhalation). Pressure that is applied or increased during an inspiration is termed pressure support. Intrinsic (auto-) PEEP Auto-PEEP is an incomplete expiration prior to the initiation of the next breath causes progressive air trapping (hyperinflation). This accumulation of air increases alveolar pressure at the end of expiration, which is referred to as auto-PEEP. Auto-PEEP develops commonly in high minute ventilation (hyperventilation), expiratory flow limitation (obstructed airway) and expiratory resistance (narrow airway). Once auto-PEEP is identified, steps should be taken to stop or reduce the pressure build-up. When auto-PEEP persists despite management of its und ...
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Work Of Breathing
Work of breathing (WOB) is the energy expended to inhale and exhale a breathing gas. It is usually expressed as work per unit volume, for example, joules/litre, or as a work rate (power), such as joules/min or equivalent units, as it is not particularly useful without a reference to volume or time. It can be calculated in terms of the pulmonary pressure multiplied by the change in pulmonary volume, or in terms of the oxygen consumption attributable to breathing. In a normal resting state the work of breathing constitutes about 5% of the total body oxygen consumption. It can increase considerably due to illness or constraints on gas flow imposed by breathing apparatus, ambient pressure, or breathing gas composition. Mechanism of breathing The normal relaxed state of the lung and chest is partially empty. Further exhalation requires muscular work. Inhalation is an active process requiring work. Some of this work is to overcome frictional resistance to flow, and part is used to defo ...
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Pneumothorax
A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged tissue, and the amount of air in the space between chest wall and lungs increases; this is called a tension pneumothorax. This can cause a steadily worsening oxygen shortage and low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed. Very rarely, both lungs may be affected by a pneumothorax. It is often called a "collapsed lung", although that term may also refer to atelectasis. A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease. A secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases the risk of primary spontaneous pneumothora ...
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ConsumerAffairs
ConsumerAffairs is an American customer review and consumer news platform that provides information for purchasing decisions around major life changes or milestones. The company's business-facing division provides SaaS that allows brands to manage and analyze review data to improve their products and customer service. ConsumerAffairs was founded in 1998 by Jim Hood. The company has been headquartered in Tulsa, Oklahoma since 2010 and also has offices in Austin, Texas, the Philippines, and Argentina. It is not a government organization or a non-profit organization. The current CEO is Zac Carman. History The company was founded in 1998 by Jim Hood, an Associated Press executive, editor and reporter, as an easier way of collecting consumer opinions. In 2010, the company was purchased by Zac Carman as an "opportunity to turn customer complaints into an opportunity for brands." They moved to Tulsa, OK in 2010. In 2015, the company had a $1.1 million renovation of the Petroleum Bu ...
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Consumer Reports
Consumer Reports (CR), formerly Consumers Union (CU), is an American nonprofit consumer organization dedicated to independent product testing, investigative journalism, consumer-oriented research, public education, and consumer advocacy. Founded in 1936, CR was created to serve as a source of information that consumers could use to help assess the safety and performance of products. Since that time, CR has continued its testing and analysis of products and services, and attempted to advocate for the consumer in legislative and rule-making areas. Among the reforms in which CR played a role were the advent of seat belt laws, exposure of the dangers of cigarettes, and more recently, the enhancement of consumer finance protection and the increase of consumer access to quality health care. The organization has also expanded its reach to a suite of digital platforms. Consumer Reports Advocacy frequently supports left-wing environmental causes, including heightened regulations on auto ...
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