CPAP causes Co2 retention / edema / cardiac arrest ????

Hi guys,

I have just come across this forum and seems like a good place to ask a question about my father.

My father is currently in ICU after a cardiac arrest, Co2 and fluid retention episode. He is improving now but just found out today that the doctors think it might be his CPAP machine that has caused it.

I will write down a few facts as I know them -
- He has been on CPAP for about 5 years.
- The first episode was about 2 years ago in October 2013.
- This is the second episode that has occurred.
- Symptons include
a) tiredness / out of breath
b) massive fluid retention
c) blood gasses go out of whack
- He was took in to hospital last week and he setttled down for the night on his CPAP box and he had a cardiac arrest
- He has been heart scanned and ECG'd and they both look clear
- Currently on BiPAP and his feet have gone down a lot over the past few days as the edema has cleared out
- The doctor in the first episode described it as congestive heart failure.
- The difference this time is they noticed his blood gas levels dropped AFTER the CPAP box was put on.
- He has been fighting a losing battle with fluid retention over the past few months - cathethers / water tables - nothing seems to have helped much

Currently a COPD specialist is examining his CPAP box but I have been doing a bit of reading around and just wanted to ask if this guess was near the mark -

I have read that CPAP can cause CO2 retention in some patients where they are unable to push back against the constant pressure of the box at night. This will cause gradual increase of Co2 retention. As a knock on effect this causes fluid retention to occur because basically the symptoms of heart failure are being induced even though the ECG / heart scan says nothing is wrong with his heart. The end result is that its reasonably likely that he will need to be switched to a BiPAP box because this provides the 2 different pressure levels to ensure that he is exhaling properly and getting rid of the CO2 or maybe BIPAP with a bit of added oxygen. The failure of the CPAP is also probably due to age / and or reduced lung function - is that a reasonable assumption ?

Sorry if this all seems a bit of a jumble but hopefully it makes sense.


Thanks

mrploddy

I have CHF and use a Bilevel. Some COPD patient's do get co2 build-up and are put on Bilevel's for that reason. I'm sure his doctors are looking into it. I assume they are looking at possible diabetic issues which can also cause fluid retention.

Yes he is diabetic (type 2) and has high blood pressure but both are relatively under control with lantus pens and blood pressure tablets.

Do you know the full name and model # of his machine? Because newer ones (by 5-<10 yrs) have certain features that make exhalation easier and you decide what level to set those at. However, all masks also have a small patch of tiny holes on them that vent CO2 when you exhale, and if that gets covered by bedding, you'll rebreathe CO2, which is not a good thing, of course. Most of us have it happen on occasion, and feel a bit dizzy or disoriented when it does, but if your father was either not really aware that the vent should be left open, or covered it inadvertently when asleep, it might have impacted him more strongly than others if he was already in bad cardiac health. There are far too many factors to begin speculation about here - not knowing what machine (model #) he had, not knowing how carefully your father or family monitored his use of the machine and mask, not knowing how well he was followed by sleep medicine doctors there on a routine basis, or if his pressure settings were up to par or too low, if his mouth opened when he slept and he lost Cpap air that way (there are ways to deal with that), etc. etc. And we know nothing of his lifestyle, general sleep habits re time, whether alcohol was involved, weight issues (and certainly diabetes is a major factor). CHF is serious and Cpap alone would not necessarily be enough to counter it depending on all the above and more.

I do hope he feels better soon and is able to get back to his usual life.

The cardiac arrest occurred in a hospital setting so you would assume the nurses would have ensured it was set right.

Apparently he was fine before he slept but then at about 4am he arressted and when they did his blood gasses they had rocketed and the thing they had noticed was that he had is machine on.

I think the machine is relatively new (he got it in 2013) as it has some kind of wireless modem in it that phones home without needing to take it in for a service and the description of the nurse was "the respiratory team has taken the CPAP box to do a detailed analysis of the memory card".

They havent said for defo but a strong indication was given they thought it might be the box.

-mrploddy

Oh and just to reiterate -

- They have done multiple heart scans / ECG's and they all came back clear
- His blood pressure / diabetes have all been under control using lantus pen and medication - no immediate cause for concern
- They scanned his lungs and found no clots

So it sounds like they eliminated cardiac issues ? The head of cardiology at the hospital said they couldnt find anything wrong heart wise.

-mrplody

Ok... first of all, it's not a box, but a machine.

Secondly, that modem simply allows the fact that the machine was used for at least 4 hrs a night to be conveyed to the DME or doctor so the insurance co. will keep paying for it. It does NOT, however, tell anyone the status of a patient's condition when sleeping - that would only be available to someone with a machine that reports the medical data, not just compliance.

So they have taken his machine to check what has been happening when he exhaling ?

Would they be able to tell from the machine data if he had exhalation issues after analysis ?

-mrploddy

Don't know which machine he has, but they'll see a lot more info than just exhalation - depending on how much that model reports.

mrploddy wrote:Yes he is diabetic (type 2) and has high blood pressure but both are relatively under control with lantus pens and blood pressure tablets.

Lantus is a basal insulin. What does he use for a bolus? It's rare that someone on insulin can stay in good control without dosing for food.

The cardiac arrest occurred in a hospital setting so you would assume the nurses would have ensured it was set right.

LOL No don't assume that. They aren't trained on cpap machines and most don't want to know - that is the respiratory tech's territory.

mrploddy wrote:Hi guys,

I have read that CPAP can cause CO2 retention in some patients where they are unable to push back against the constant pressure of the box at night. This will cause gradual increase of Co2 retention. As a knock on effect this causes fluid retention to occur because basically the symptoms of heart failure are being induced even though the ECG / heart scan says nothing is wrong with his heart. The end result is that its reasonably likely that he will need to be switched to a BiPAP box because this provides the 2 different pressure levels to ensure that he is exhaling properly and getting rid of the CO2 or maybe BIPAP with a bit of added oxygen. The failure of the CPAP is also probably due to age / and or reduced lung function - is that a reasonable assumption ?

Your assumption is likely correct. It is the reason why they put my brother on a bipap. In his case, however, he did not have apnea, but reduced lung function so they were on top of that being an issue.

Did the nurses note if the room lights were on or off? That could be a factor also. It sounds to me like his health treatment is being poorly done. It sounds like no-one is taking his treatment seriously, including himself.

I am also type 2, using insulin and pills, with a quad by-pass, the difference is I took the time to learn how my diseases operate, and how best to keep my defective body running. I monitor my blood sugar levels 3 or 4 times daily as needed, I use a mixture of two types of insulin mixed according to my best guess of need.

I use my CPAP (MACHINE) all night every night and monitor my results with the software that reads the data the machine gives off. Having this advantage is a must, but it like most things requires personal effort.

Having others in charge of your life, isn't the best option, it's a 24/7 job, one might say endless.... Jim

I am 59 yhears old. Since I started with the bipap machine, I feel like I am getting no sleep when I wake up. This day, I woke up past my 9/a/m medicine time, in extreme pain when I woke up at noon, I could hardly move. I stretched, my right hip was out of, adjustment, my hardware in my neck, etc...

Then I got a call from a friend to go for a walk. I have a damaged prosthetic right knee which had been through 4 surgeries and a manipulation.

Whe I ust the machine, i have the "AMARA VIEW SIZE MEDIUM."I went to ice my knee and fell asleep withing minutes of putting the ice pak on my knee in my recliner, upright.

I went to walk onj a path so I did not have to use the rollator, due to extreme atrophy in my knee to build it up in a non-violent atmosphere. I will look for Yoga.

I do not know what is wrong with me and how I can tell the machine is not functioning properly. I am with a company "Absolute Respiratory Care in RI., the owner refuses to send anyone down to check the machine. I decided to call medicare and let them know I had made an appointment with them, it is very difficult for me to travel. They will put the machine on the meteorometer, I will watch it for two hours, and be fitted for a full face mask, mine is considered a full face mask but does not cover the nose, it is squishing my nose at the end of the bone at the top of the nose, and causing my left eye to have lined in the skin next to the straps, I use 100% cotton face cloth under the four straps that come over my face, into the mask, the mask is causing lines in my face as well.

I have had problems with this machine since I started. I got better sleep with two faans blowing at my face, but I need to have something incase I need to go somewhere which I will. I found a leek in both of the hoses I ordered, which both of them I am not supposed to pay for since my income is extremely low SSDI monthly.

The owner is stubborn and rude. I cannot leave this company since I have to stay with a company for a year.

The doctor believes that she is not adjusting the pressures, I have seen it on the machine.

IO called the Medical board, I do not know what they can or if they will do anything.

I have had to pay for defective equipment twice now.

The headgear went three months ago, I have to pin the old headgear, the velcro is not sticking anymore. They should have filed a form with a code. This is shaking up my life, and I want to sue due to I think I am being poisoned by CO2.

How do I find out?

I never had heart problems, now I do

Thank you for your response

whitethunder44 wrote:I am 59 yhears old. Since I started with the bipap machine, I feel like I am getting no sleep when I wake up. This day, I woke up past my 9/a/m medicine time, in extreme pain when I woke up at noon, I could hardly move. I stretched, my right hip was out of, adjustment, my hardware in my neck, etc...

Then I got a call from a friend to go for a walk. I have a damaged prosthetic right knee which had been through 4 surgeries and a manipulation.

Whe I ust the machine, i have the "AMARA VIEW SIZE MEDIUM."I went to ice my knee and fell asleep withing minutes of putting the ice pak on my knee in my recliner, upright.

I went to walk onj a path so I did not have to use the rollator, due to extreme atrophy in my knee to build it up in a non-violent atmosphere. I will look for Yoga.

I do not know what is wrong with me and how I can tell the machine is not functioning properly. I am with a company "Absolute Respiratory Care in RI., the owner refuses to send anyone down to check the machine. I decided to call medicare and let them know I had made an appointment with them, it is very difficult for me to travel. They will put the machine on the meteorometer, I will watch it for two hours, and be fitted for a full face mask, mine is considered a full face mask but does not cover the nose, it is squishing my nose at the end of the bone at the top of the nose, and causing my left eye to have lined in the skin next to the straps, I use 100% cotton face cloth under the four straps that come over my face, into the mask, the mask is causing lines in my face as well.

I have had problems with this machine since I started. I got better sleep with two faans blowing at my face, but I need to have something incase I need to go somewhere which I will. I found a leek in both of the hoses I ordered, which both of them I am not supposed to pay for since my income is extremely low SSDI monthly.

The owner is stubborn and rude. I cannot leave this company since I have to stay with a company for a year.

The doctor believes that she is not adjusting the pressures, I have seen it on the machine.

IO called the Medical board, I do not know what they can or if they will do anything.

I have had to pay for defective equipment twice now.

The headgear went three months ago, I have to pin the old headgear, the velcro is not sticking anymore. They should have filed a form with a code. This is shaking up my life, and I want to sue due to I think I am being poisoned by CO2.

How do I find out?

I never had heart problems, now I do

Thank you for your response

You're not giving us much information to go on.
Get Sleepyhead software (it's free) and monitor your therapy.
And, you're not being poisoned by CO2 unless you're sleeping on your face in the pillow and there's nowhere for the exhaust vent air to go.
In all probability, your therapy is not optimal or negated by leaks. But, get the software and take control of your own therapy and find out.
And, order some new headgear from https://www.cpap.com
Trying to blame everybody else is NOT the way you take control of your own therapy.

And, if the Velcro is full of lint, pick or brush it out. You can also find Velcro replacement rolls at hardware sections of stores. I just used some to repair the back strap fasteners of my wife's sandals sometime back. I trimmed the old off and used Krazy Glue to attach the new and trimmed it to fit the contour. Worked like a charm.


Den

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