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36 Cards in this Set
- Front
- Back
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What is the purpose of Positive Airway Pressure (PAP)? |
To deliver a continuous flow of air that increases pressure in the upper airway and prevent airway collapse
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What are the three types of PAP?
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Continuous Pressure (CPAP)
Bilevel PAP (BPAP) Auto-Titrating (APAP) |
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What are the benefits of PAP?
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1) Immediately effective, relatively non-invasive
2) Reduce complaints 3) Modifies consequences of OSA |
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What main problems are associate with PAP?
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1) Mask discomfort
2) Patient acceptance (of lack of) 3) Aerophagia 4) Chest Discomfort |
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What is aerophagia?
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the swallowing of air
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What does PAP selection depend on?
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1) Shape of face
2) Facial Hair 3) Patient ability to breathe through nose 4) patient preference |
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What are solutions for dryness due to PAP?
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1) Humidification
2) Prevent Leaks |
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What are solution to claustrophobia due to PAP?
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1) Less cumbersome interface
2) Desensitization |
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What are solution to aerophagia due to PAP?
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1) Body positioning
2) Reduce mean airway pressure |
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What are solutions for rhinitis and nasal congestion?
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1) Humidification
2) Nasal steroids or decongestants |
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What is a solution to air leaks?
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Proper mask and headgear
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What is the recommended starting CPAP pressure for adults (over the age of 12)?
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4 cm
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What is the recommended starting CPAP pressure for kids (under the age of 12)?
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4 cm
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What is the recommended maximum CPAP pressure for adults?
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20 cm
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What is the recommended maximum CPAP pressure for kids?
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15 cm
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How often, by how much, and until when should CPAP pressure be increased?
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Every 5 minutes, by at least 1 cm till obstructive events are eliminated.
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For a child, when should CPAP titration be increased?
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After 1 obs apnea
After 1 obs hypopnea After 3 RERAs or 1 minutes of loud unambiguous snoring |
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For an adult, when should CPAP titration be increased?
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After 2 obs apneas
3 obs hypopneas 5 RERAs or 3 minutes of loud unambiguous snoring |
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What is the AHI criteria for a Split Night Protocol
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AHI greater than or equal to 40 for 2 hours of PSG
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How long should CPAP titration be carried out during a Split Night Protocol?
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3 hours
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When is bilevel PAP (BPAP) used?
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1) When a high level of pressure is needed and the pt has trouble with fixed pressure
2) Hypoventilation is present |
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What is BPAP useful for treating?
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1) Restrictive lung disease
2) Hypoventilation syndrome associated with daytime hypercapnia |
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What is IPAP?
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Inspiratory Airway Pressure
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What is EPAP?
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Expiratory Airway Pressure
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What is the goal of EPAP?
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set lowest to prevent airway collapse during expiration
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What is the goal of IPAP?
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set higher to prevent airway collapse during inspiration
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What is the recommended starting IPAP Pressure for kids and adults?
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8 cm
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What is the recommended starting EPAP pressure for kids and adults?
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4 cm
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What is the recommended maximum EPAP/IPAP pressure for kids?
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20 cm
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What is the recommended maximum EPAP/IPAP pressure for adults?
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30 cm
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What is the recommended minimum IPAP-EPAP differential for kids and adults?
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4 cm
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What is the recommended maximum IPAP-EPAP differential for kids and adults?
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10 cm
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When should IPAP be increased for kids?
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After 1 obs hypopnea
3 RERAs or 1 minute of loud snoring |
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When IPAP be increased for adults?
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After 3 obs hypopnes
5 RERAs or 3 minutes of loud snoring |
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What is the purpose of APAP?
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APAP increases CPAP to eliminate airway obstruction then lowers overnight to keep CPAP at lowest possible level
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What medical conditions is APAP not recommended for?
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1) Congestive Heart Failure
2) Hypoventilation syndromes 3) Chronic lung disease 4) Absence of snoring |
