What is an absolute contraindication for CPAP use?

An absolute contraindication for CPAP (Continuous Positive Airway Pressure) use is an inability to maintain airway patency. This is crucial because CPAP relies on the patient being able to create a seal with their lips around the mask and maintain an open airway in order for the pressure to provide the necessary assistance with their breathing. If a patient cannot maintain airway patency, such as in cases of altered mental status, severe facial trauma, or other conditions that impede their ability to protect their airway, the use of CPAP could lead to inadequate ventilation, increased risk of aspiration, or potential airway obstruction.

In this context, respiratory distress might indicate that a patient is struggling to breathe, but it does not automatically exclude CPAP use. A history of moderate asthma does not prevent the use of CPAP, as asthma can often be managed with this modality in certain situations, providing it is safe to do so. Similarly, age over 8 years does not pose a limitation for CPAP; as long as the criteria for CPAP use are met and the patient can cooperate, it can generally be applied to older children and adults.