Wednesday, December 23, 2009

Indications for BiPAP

To learn the indications for BiPAP and CPAP, please read my post "CPAP -vs- BiPAP: What You Need to Know."


18 comments:

Matt said...

"I have seen BiPAP ordered on patients that do not fill the above indications. The following are some examples: Pulmonary edema to force the fluid out of the lungs (CHF and pneumonia"

While BIPAP does not "force" the fluid out of the lungs, it's usage in treating acute pulmonary edema has been well documented in the critical care setting.

A high level of EPAP (ie + 1O, + 12) acts to decrease venous return thus decreasing ventricular preload and allows time for the left Ventricle to "pump" the pulmonary edema out of the lungs.

Anonymous said...

I heard bipap helps bradycardia....any thoughts on this?

Rick Frea said...

Never heard anything about that. Have you seen any studies?

Anonymous said...

Gollee gee willikers....

Respiratory therapists are so smart, and doctors are so dumb. We know nothing about respiratory care.

Is that the (nonsensical) point you're trying to make with your little quips about doctor 'mistakes'?

Perhaps you don't know as much as you think you do. Go to medical school, and find out for yourself.

Rick Frea said...

If I thought I was smarter than a doctor I'd be a doctor. The whole reason the respiratory profession was created (BY A PHYSICIAN) was because respiratory therapy was beyond the scope of the physician's knowledge (quote by EGAN). We RTs are the experts in respiratory therapy. That's all we do. We study it. We eat it. We live it. We are a part of the patient care team, and it's our job to make recommendations to the physician. Then the doctor makes the final decision. If anything, the reason I write stuff like this is our of respect for the medical profession.

Rick Frea said...

Thats respect for the medical profession, and respect for the patient. BiPAP is not fun to wear. And We RTs just want to make sure if it's going to be used, the doctor is aware of the facts.

Anonymous said...

Comments by the previous anonymous poster sound defensive, childish and quite unexpected from a physician.

Rick Frea said...

True, and it was anonymous, so it probably wasn't even a physician.

Anonymous said...

I have a relative recently put on BiPAP. He has Bullous Lung disease and you list this as a contraindication. Would you please post a medical reference so that I may educate myself before I consult the physician. Thanks

Anonymous said...

Hi. I think I misread your contraindication list. The contraindication was for bullous lung disease pneumothorax, not just bullous lung disease. If I'm wrong please post. Thanks again for an informative block on NPPV.

Anonymous said...

We use BiPap for acute pulmonary oedema all the time in conjunction with frusemide to extremely good effect. Why do you feel this is not an appropriate management?

Rick Frea said...

I am not opposed to BiPAP for heart failure. I am opposed to the myth that BiPAP will somehow force fluid out of the lungs. This is not true, as BiPAP decreases cardiac output and helps by that means. I added a link to the post if you wish to check it out: the 17 biggest myths of respiratory therapy. I explain this in more detail in the post. Thanks.

Robert22 said...

I work at a hospital where a physician orders Bipap, on 2 hrs, off 2 hrs as a therapy. Usually the patient has pneumonia or plural effusion. Any thoughts.

Anonymous said...

I was wanting to know if there is anyway to check the history of when changes to settings were made?

john bottrell said...

Not for any bipap machine I have ever used. Why?

Unknown said...

I had to laugh at the annoy a patient thing (raise blood pressure) because my use of BiPAP and CPAP is that CPAP is annoying and BiPAP a comparative dream machine.

JimG said...

I am a long-time user of a BIPAP machine. Is anyone aware of any long-time negative effects of using this machine? Recently (past 6 months or so) I have been experiencing a shortness of breath.

john bottrell said...

Generally, if your physician has prescribed BiPAP for you, he believes there are more serious negative effects if you don't use it exactly as prescribed. If you think your BiPAP is not working properly, it's important to have it checked. Otherwise, if you are experiencing shortness of breath, it's important that you call your physician right away.