Bipap is working as a ventilator

[Dan6]

My brother is in ICU and two of three Dr's and a nurse said that the bipap was doing the breathing for him.

When 02 sats are down they just up the pressure.

[BlackSpinner]

My brother is in ICU and two of three Dr's and a nurse said that the bipap was doing the breathing for him.

When 02 sats are down they just up the pressure.

Is the hospital too cheap to get an RT involved?

[jamiswolf]

My brother is in ICU and two of three Dr's and a nurse said that the bipap was doing the breathing for him.

When 02 sats are down they just up the pressure.

Hi Dan,
Sorry your brother is so sick. There are machines that are capable of ventilation. Noninvasive Ventilation is the phrase used for that. They aren't a regular BiPap but one with a back up rate and enough pressure to promote better ventilation. The Respironics BiPap asv advanced and the AVAPS machines can serve that function, but in that setting...it's probably something a little more sophisticated like the Trilogy 100. This allows breathing assistance without using an endo-tracheal tube or tracheotomy. Did that help?
Jamis

[jamiswolf]

,,,or are you referring to his home BiPap machine in use at the hospital?

[Dan6]

Hi Dan,
Sorry your brother is so sick. There are machines that are capable of ventilation. Noninvasive Ventilation is the phrase used for that. They aren't a regular BiPap but one with a back up rate and enough pressure to promote better ventilation. The Respironics BiPap asv advanced and the AVAPS machines can serve that function, but in that setting...it's probably something a little more sophisticated like the Trilogy 100. This allows breathing assistance without using an endo-tracheal tube or tracheotomy. Did that help?
Jamis[/quote]

Need to look at the machine tomorrow. They had pressure set at 20/15 with a leak rate of 130, the ill fitting mask was almost bouncing off his face.

After i complained they dropped the rate to 15/10 then 13/8. Each time his o2 went up and he was resting a lot better.

[jamiswolf]

Dan6 wrote: After i complained they dropped the rate to 15/10 then 13/8. Each time his o2 went up and he was resting a lot better.

I'm a little confused by this situation. He should be using his normal pressure and if O2 is low they can add that through the BiPap hose.

I now agree with Blackspinner. This should be managed by an RT.
J

[Dan6]

That is the sad part RT is managing it. When I questioned the mask fit and said it was leaking too much to be effective the RT explained that it was by design and tried to show me the vent on the mask. When I said that 114 was far above the designed leak rate for the mask and suggested that he should get a mask that would fit and reduce the pressure, he disappeared. After speaking with the doctors the pressure was reduced, mask adjusted properly and CO2 down 49 points from yesterday.

He may not leave ICU and if he does it will be to go to hospice. I just can't imagine the torture of being restrained and having a pressure that I can't really breath against.

[jamiswolf]

Dan6 wrote: He may not leave ICU and if he does it will be to go to hospice. I just can't imagine the torture of being restrained and having a pressure that I can't really breath against.

Hi Dan,
Is the reason he's on the BiPap-as-ventilator related to narcotic pain medication? And also...just to re-assure you...BiPaps are machines with an automatic lower exhale pressure and most likely he is not struggling to breath out. I use a BiPap nightly with pressures higher then your brother uses and it's actually quite comfortable to breath with. The mask is probably the issue. Ask the RT if he has any cushion gaskets. Helps with leaks and with comfort. I know what you are going through is hard. We'll try and help in any way we can.
Take care,
Jamis

Edit: And the masks do have a built in leak rate to blow off the CO2...so perhaps his leaks aren't that bad.

[icipher]

Sounds like he is using an ASV type machine. Do you mind me asking what his ailment is?

[jamiswolf]

Hi Dan6,
Hope your brother is resting better. Curious to know if you found out what machine the BiPap is.
J