Implementation of Boussignac continuous positive airway pressure in the coronary care unit: Experiences and attitudes

Dieperink, Willem; Nijsten, Maarten W.N.; van de Stadt, Mark; van der Horst, Iwan C.C.; Aarts, Leon P.H.J.; Zijlstra, Felix; Jaarsma, Tiny

doi:10.1016/j.hrtlng.2007.12.006

« Previous Next »Heart & Lung: The Journal of Acute and Critical Care
Volume 37, Issue 6 , Pages 449-454, November 2008

Implementation of Boussignac continuous positive airway pressure in the coronary care unit: Experiences and attitudes

Willem Dieperink, RN, MSc
- Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
- Surgical Intensive Care Unit, University Medical Center Groningen, University of Groningen, The Netherlands
- Corresponding author: Willem Dieperink, RN, MSc, Surgical Intensive Care Unit, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
Maarten W.N. Nijsten, MD, PhD
- Surgical Intensive Care Unit, University Medical Center Groningen, University of Groningen, The Netherlands
Mark van de Stadt, RN
- Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
Iwan C.C. van der Horst, MD, PhD
- Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
Leon P.H.J. Aarts, MD, PhD
- Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, The Netherlands
Felix Zijlstra, MD, PhD
- Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
Tiny Jaarsma, RN, PhD
- Thoraxcenter, Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands

Objective

Boussignac continuous positive airway pressure (BCPAP) delivered by face mask is useful for patients with acute cardiogenic pulmonary edema (ACPE). Although BCPAP is medically effective, we observed that not all suitable patients received it. In this descriptive, prospective, cohort study, we explored the experiences and attitudes of both patients and staff with BCPAP.

Methods

Patients were interviewed 12 to 48 hours after treatment with BCPAP. Nurses on the coronary care unit were interviewed on their knowledge, skills, experiences, and opinions concerning BCPAP.

Results

Of 117 patients with ACPE, 87 patients (74%) received BCPAP treatment. It was decided not to administer BCPAP in 30 patients with ACPE (26%). Patients who received BCPAP found that the reduction of dyspnea outweighed any discomfort. Barriers for the use of BCPAP were not related to nurses' skills but to the following: the nurses' belief that BCPAP created major discomfort, the lack of guidelines, the ultimate improvement of oxygenation without BCPAP, and the more labor-intensive treatment.