Chapter 12: Respiratory care, CPR and blood transfusion
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Complications
With any circuit that includes the use of PEEP, there is the possibility of reduction in cardiac output due to an increase in intrathoracic pressure. However, spontaneous ventilation decreases both the incidence and the severity of this complication if patients have had their fluid balance optimized (Cortegiani et al. [51]).
There is also a risk of gastric insufflation (blowing of air causing gastric distension), which can lead to vomiting and aspiration, although the risk is minimized when PEEP is used in awake patients or by the insertion of an orogastric or nasogastric tube (Vadde and Pastores [277]).
Preventative pressure dressings should be considered in underweight patients or those with bony facial prominences. There should also be regular skin checks to ensure that the tight‐fitting face‐mask required for CPAP is not compromising the skin integrity of vulnerable areas on the bridge of the nose and over the ears (Scott [246]).
