slideshow widget

Wednesday, October 8, 2014

Oxygenating with home BiPAP and CPAP machines

When using a ventilator, either for mechanical ventilation or noninvasive ventilation, a fixed FiO2 is set during ventilatory support. This is the best way of supplying supplemental oxygen to patients, especially because it may be adjusted to maintain a desired saturation.

However, when using a patient's home noninvasive ventilation equipment, either set up for BiPAP or CPAP, oxygen is typically placed directly into the circuit using a constant flow.  When this occurs, the amount of oxygen actually inhaled depends on a variety of factors:
  • Oxygen flow
  • Leakage
  • Circuit
  • Interface (face mask, nasal mask, etc.)
  • Location of where oxygen is bleed into the system
Studies are still inconclusive as to where the best place to insert the oxygen into the system.  Some therapists place it near the machine, while others place it near the patient interface.  Ideally, the oxygen flow should be adjusted to maintain a desired Spo2.  This may be important for patients who are using their home units in the hospital setting.  

For patients who present in acute respiratory failure, when adequate oxygenation is not obtained with a patient's home unit, a ventilator (which may include a noninvasive ventilation device such as a Vision or V60) should be used in order to deliver a fixed FiO2 that can be easily adjusted to maintain an adequate SpO2.

  1. Storre, Jan H, Sophie E. Huttmann, Emelie Ekkernkamp, Stephan Wlterspacher, Claudia Schmoor, Michael Dreher, and Wolfram Windisch, "Oxygen Supplementation in Noninvnasive Home Mechanical Ventilation: The Crucial Roles of CO2 Exhalation Systems and Leakages," Respiratory Care, January, 2014, volume 59, number 1, pages 113-119
RT Cave Facebook Page
RT Cave on Twitter
Print Friendly and PDF

No comments: