PEEP in non invasive ventilatory treatment of worsened BPCO

Acute respiratory failure due to exacerbation of chronic pulmonary disease is usually treated with bilevel pressure non invasive ventilation. An high inspiratory pressure is used to improve tidal volume, a lower expiratory pressure is used to neutralize end expiratory positive pressure of patient (PEEPi) caused by flow limitation and airway trapping. When ventilators for bilevel pressure ventilation are not available, is useful to administer to patient an external low (5cmH2O) positive pressure with simple CPAP systems (Continuous Positive Airway Pressure, such as Venturi like flow generator) largely available and well known everywhere.