CONTINUOUS POSITIVE AIR PRESSURE (CPAP) or POSITIVE AIRWAY PRESSURE (PAP)

It is a mask-like device with a machine that pushes air into the nostrils to keep the airway open during sleep at night. A CPAP machine delivers continuous positive air pressure through the nose and mouth via a special mask that a person wears while asleep and also it helps patients breathe so that they can stay asleep throughout the night. The CPAP machine maintains a constant pressure of oxygen in a patient's airways, keeping them open and functioning fully.

Who Needs a CPAP Machine? People suffering from obstructive sleep apnea, which can affect the way a person breathes while sleeping, use CPAP machines to make their breathing more efficient and to reduce their risk of developing certain conditions such as heart failure. PAP ventilation is also commonly used for critically ill patients in hospital with

respiratory failure, coronary artery disease (CAD) or heart failure, and in newborn infants (neonates). In these patients, PAP ventilation can prevent the need
for tracheal intubations, or allow earlier extubation. Sometimes neuromuscular diseases use this variety of ventilation as well. patients with

How Does CPAP Work?

FOR OBSTRUCTIVE SLEEP APNEA CPAP pushes a steady stream of air into the nose and throat so that your airway does not collapse when you breathe in. Obstructive sleep apnea (OSA) occurs when the patient stops breathing during sleep, because the airways close off. The breathing stoppage causes the person to wake up, even without realizing it, causing fatigue, distractibility and irritability. The CPAP machines, keep the airways open during sleep so that breathing is maintained. FOR NEONATES In the neonate with respiratory distress syndrome, this keeps the alveoli at the end of the airways from collapsing due to a lack of surfactant. The CPAP machine itself does not breathe for the patient, although many preterm infants may be on ventilators as well. It simply maintains the spherical shape of the alveoli so that the infant or the ventilator can work to exchange oxygen and carbon dioxide properly. FOR HEART FAILURE A CPAP machine delivers a continuous stream of air into the patient's nose and mouth through a mask, preventing blockage and the strain on the heart and risk to the patient's life this blockage can cause. FOR RESPIRATORY ILLNESS CPAP are only for treatmentthey do not cure respiratory problems. Depending on the condition, a cure may require surgery or other medical interventions. CPAP, however, can eliminate the complications of respiratory problems, while avoiding high-risk interventions.

The CPAP breathing machine includes a CPAP mask connected via a long tube to the machine itself. Within the machine unit is a motorized air pump to provide pressurized air, as well as an air filter and a humidifier. The filter removes air impurities to ensure a supply of clean air, while the CPAP humidifier adds moisture to the air to prevent the mouth and throat drying out during sleep. 3 MOST COMMON TYPES OF CPAP: CPAP NASAL MASK - is the first mask most people will try, and is a half-mask which fits over the nose, leaving the mouth unobstructed. NASAL PILLOW MASK better for patients who sleep on their front side wherein it fits more snugly around the nostrils than a traditional nasal mask. FULL FACE MASK covers the mouth as well as the nose which improves efficacy of the CPAP unit as it prevents pressurized air escaping from sides of the mask.

PHOTOTHERAPY OR LIGHT THERAPY

Phototherapy, also known as light therapy, is a skin condition treatment that uses artificial
light wavelengths from the sun's ultraviolet field. Generally, phototherapy is administered with the patient standing in the center of a cabinet affixed with lighting around the walls. Phototherapy works to reduce inflammation, remove abnormal cells and make a change in the skin's immune system. FUNCTION: When other treatments have failed, phototherapy treatments may be used for skin conditions such as psoriasis, vitiligo, eczema, itchy skin and skin-based lymphoma. Most often it is used as a treatment for newborns with excessively high bilirubin levels, which is a condition that is common but can be frightening at first to new parents. Babies may have phototherapy in the hospital or at home. There are various ways phototherapy can be administered, but no matter what equipment is used, the baby receiving phototherapy must be monitored, eating well and well hydrated.

TIME FRAME: Phototherapy is usually given to patients two to three times a week for anywhere
from half a minute to 10 minutes. The dosage increases with each treatment, and it is typical for a patient to need 20 to 30 treatments.

TYPES: Phototherapy treatments can either be UVA or UVB. The UVA type is typically given
along with a light sensitizing tablet, cream or lotion, while UVB makes use of the UV rays' sun burning elements.

CONSIDERATIONS: Fair-skinned people who burn easily, people previously exposed to skin
cancer, people with suppressed immune systems and those who may be targets for sunburns due to certain medical conditions are not acceptable candidates for phototherapy.

WARNING: Short term side effects may include itchy skin, burning and blistering. Long term side
effects could be skin cancer, freckling and the premature aging of skin. PHOTOTHERAPY FOR NEW BORNS

REASONS TO USE PHOTOTHERAPY: The primary reason a newborn needs phototherapy is

excessively high bilirubin levels or levels that get too high too fast. Any of these can be caused by infection, liver ailments, prematurity or metabolic disease. Almost all healthy babies develop jaundice in the first few days of life, but very few require phototherapy. Bilirubin is present in bile in the body and has a dark yellow color. It is a by-product of the breakdown of old red blood cells. The immature liver of a newborn is less efficient at breaking down the bilirubin. This causes a build up of bilirubin, leading to the yellow color of the skin (jaundice). Phototherapy helps the baby to metabolize the excess bilirubin in her blood. According to WebMD, a study from Johns Hopkins University in 2002 showed that bilirubin is an antioxidant that protects babies' cells from damage.

THE PROCESS: The most common place for an infant to receive phototherapy is in the hospital.
If this is the case, she will be placed in an isolette (some refer to them as "incubators"), which looks like a large clear plastic box. It is a comfortable bed for the baby and the air inside is warmed. The baby will be undressed and wear eye patches to protect her eyes. In some cases, her diaper will be open to expose as much skin to the light as possible. If she is unable to breast- or bottlefeed, she will be given intravenous fluids to keep her hydrated. The more wet and soiled diapers she has, the quicker the bilirubin will be eliminated. You will still be able to take her out for short periods to hold and feed her. Often a phototherapy light will shine on her from above the isolette. For some infants, a second "bank" of lights is used in front of the clear bed.

HOME PHOTOTHERAPY: Home phototherapy uses halogen lights and the lights are embedded
in "blankets" that can wrap around your baby or in a special bed. In these cases the baby does not need eye patches, as the light does not shine in her eyes. Home phototherapy is not appropriate for every situation. Your pediatrician will help you decide if it is right for your baby.

TIME FRAME: Blood tests will determine how long your baby will need phototherapy. Treatment
lasts from one to several days depending on how fast the bilirubin levels stabilize.

SUNLIGHT MISCOPNCEPTION:

While sunlight is, by definition, the "photo" part of phototherapy, it is not appropriate as treatment for babies with elevated bilirubins. Exposure to the sun can result in a sunburn, and, for any type of light to be an effective therapy, babies must be naked or almost so while exposed to the light; most infants are not able to maintain a stable body temperature outdoors, especially if they are undressed. Clinical phototherapy in the hospital or at home is the only safe choice.

CONTINUOUS AIRWAY PRESSURE (CPAP)

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PHOTOTHERAPY
Presented by:

Julie Anne Custodio BSN 2-A