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.
References:
- 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
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