ventilator vs. bipap

[a dazed and confused 2]

my mother in law is in the hospital due to a heart attack. she has been there for a week and when she was brought in by ambulance she was put on bp meds and they put her on a ventilator and placed in a coma. after day 3 they removed the ventilator and stopped the meds that was keeping her in a coma and she was doing really well. it had been 8 hours then a cleaning aide came in and used bleach and caused her to have breathing problems(she has copd and emphasema) which she uses oxygen on a daily basis. at that time the doctor decided to put her back into a coma and put the ventilator back in. i feel that using a bipap machine, along with a breathing treatment, which they have never used with her, would be sufficient for her issues. my question is should the family suggest this to the doctor or am i completely wrong about this? i feel like keeping her on the ventilator and drugs is a bit much, considering she can breathe on her own. another 3 days is their plan, but seems not needed to me.. thanks for any response..

[Sonnyboy]

If this was my mother-in-law I would get a second opinion from a cardiologist and a pulmonologist.

[HoseCrusher]

You can always ask another doctor for a second opinion...

[lilly747]

It's never wrong to talk to a doctor about your concerns and make suggestions.

[bwexler]

I always ask questions of all doctors involved in treating me or mine. I often make suggestions on how I think the treatment should be handled. If the doctor doesn't cooperate or convince me he is right, I have been known to change doctors.

I insist on knowing what is being done and why. I tend to be a control freak on occasion. But only when others disagree with me.

[archangle]

Leave it alone. If nothing else, the staff is probably more familiar with the "ventilator" than the bilevel machine.

The ventilator can probably deliver any therapy that the bilevel machine can deliver, so there's no downside as long as they do it right. The ventilator probably has more alarms and better monitoring. Plus it may be set to something like a "timed or spontaneous/timed" mode that will automatically kick in if she stops breathing or doesn't breathe well enough on her own.

[Sir NoddinOff]

Leave it alone. If nothing else, the staff is probably more familiar with the "ventilator" than the bilevel machine.

The ventilator can probably deliver any therapy that the bilevel machine can deliver, so there's no downside as long as they do it right. The ventilator probably has more alarms and better monitoring. Plus it may be set to something like a "timed or spontaneous/timed" mode that will automatically kick in if she stops breathing or doesn't breathe well enough on her own.

+1
You appended to a very old post, sooooo.... the person you are referring to is in very critical condition and I think you have to defer to the medical professionals in this case. You can ask for second opinion but it sounds like your team has things under control. BTW, If there is a serious lapse in her breathing a BiPAP has absolutely no way of making a person breathe. Not sure what you meant by breathing treatment, maybe you meant exercises.

[Matt00926]

if you are in acute respiratory distress, have reduced consciousness, have a severey compromised respiratory drive, cannot maintain a patent airway, are having an acute exacerbation of COPD, or your cardiovascular status is unstable, bipap can be contraindicated.

the bipap reduces work of breathing but the vent is going to basically take over work of breathing for the patient and allow their muscles to get the badly needed rest that they do

[a dazed and confused 2]

im just thinking the bipap is alot less intrusive/comfortable and it doesnt require that she be placed into a coma, life support seems to be very self explanatory and she hasnt stopped breathing, hence needing life support, just needs some assistance in breathing. i believe a ventilator is meant to keep you alive if your body cant do it on its own... and to be out for 3 and 4 days, seems crazy at the least, and sure i can get a second opinion, i just think that i shouldnt have to, this is something one should know,,, and breathing treatments, an inhalation solution dispensed through a nebulizer, usually albuterol....

[archangle]

i believe a ventilator is meant to keep you alive if your body cant do it on its own..

A modern ventilator can do anything from straight CPAP to bilevel all the way up to complete breathing for a patient who can't breathe at all.

The staff probably knows how to use the ventilator much better than they know how to use a bilevel machine.

Leave it alone.

[mjmia3]

In pediatrics, there is a chance we would try BiPAP first, or even CPAP for respiratory distress. If they are in respiratory failure, they get intubating and placed on a ventilator. In the adult population, you go straight to the ventilator when in or approaching respiratory failure. They can do breathing treatments in the ventilator. There is a huge risk of skin breakdown with CPAP or BiPAP when you are older too. And, intubating a patient in a calm, planned situation it has a better chance of going smoothly than if she was on BiPAP and coded/crashed requiring immediate intubation and ventilation. They are probably looking out for her in the long run. I'm so sorry to hear about your family. Good luck. Don't be afraid to ask your respiratory therapist questions about the vent. You will likely learn a lot. With the ventilator, you will probably see a value for PEEP, which is like CPAP (constant flow in the circuit to provide that steady lower pressure. A tidal volume (size of each breath), a respiratory rate (somewhere between 12-20 for instance), and a pressure support for any spontaneous breaths. The pressure support is the amount of pressure increase above PEEP to supplement the spontaneous breath. Here is where I may lose you. If the PEEP is 6 and the pressure support is 8, that would be like breathing on a BiPAP of 14/6 for the pressures So, each time she takes a spontaneous breath she's on "BiPAP like" settings. When the ventilator is working for her, it delivered the set rate and targets the set tidal volume that is set.

[recallsleep]

You can check it on http://bit.ly/cpap-vs-bipap and if you have any query about it then you can contact me directly