Contraindications to CPAP include all of the following except which?

• A. Apneic patients
• B. Chest trauma
• C. Hypotension
• D. Chronic Obstructive Pulmonary Disease

Answer: (D)

Continuous positive airway pressure helps keep alveoli open and reduces the work of breathing by providing a constant pressure to support ventilation. Because it relies on the patient to breathe spontaneously and to protect their airway, CPAP isn’t appropriate for someone who is apneic or cannot follow commands, since there would be no active ventilation and a higher risk of airway compromise. It also raises intrathoracic pressure, which can drop venous return and lower blood pressure, so it’s avoided in patients who are hypotensive. Chest trauma or a suspected pneumothorax makes CPAP risky because the added pressure can worsen air leaks or hide signs of a developing pneumothorax. Chronic Obstructive Pulmonary Disease, however, is not a contraindication; CPAP can be beneficial in COPD patients with acute respiratory distress or edema, helping oxygenation and decreasing the work of breathing, provided there is careful monitoring for CO2 retention and the patient can maintain airway protection and spontaneous respiration.