Continuous positive airway pressure (CPAP) would be contraindicated in which scenario?

Continuous positive airway pressure (CPAP) would be contraindicated in which scenario?

• A. Mild SOB with normal BP
• B. Hypercapnic COPD with stable vitals
• C. Shortness of breath and a blood pressure of 76/56 mm Hg
• D. Anxiety with hypoxemia

Answer: (C)

Continuous positive airway pressure improves oxygenation by keeping alveoli open, but it also increases intrathoracic pressure and reduces venous return to the heart. In someone with severe hypotension or shock, this drop in preload can drastically lower cardiac output and worsen blood pressure and organ perfusion. Therefore CPAP is contraindicated when there is hemodynamic instability. The other scenarios involve either stable blood pressure or situations where airway support can be provided safely or with different ventilation approaches, so they do not carry the same immediate contraindication.

Continuous positive airway pressure improves oxygenation by keeping alveoli open, but it also increases intrathoracic pressure and reduces venous return to the heart. In someone with severe hypotension or shock, this drop in preload can drastically lower cardiac output and worsen blood pressure and organ perfusion. Therefore CPAP is contraindicated when there is hemodynamic instability. The other scenarios involve either stable blood pressure or situations where airway support can be provided safely or with different ventilation approaches, so they do not carry the same immediate contraindication.