How long can a patient be on BiPAP before needing intubation?

Occasionally I check my statcounter to see what searches are leading readers to RT Cave.  Assuming the queries were not answered, I provide here my humble response.

1.  bipap for hyperventilation:  I've never heard of it being used for that. 

2.  what happens if you suddenly stop advair:  I think it's such a small amount of steroid you shouldn't have to wean off it.  Yet if that small amount of steroid is keeping down the inflammation and controlling your asthma, you might be setting yourself up for an impending asthma problem down the road.

3.  quitting symbicort:  Same.  Don't just quit taking any medicine without consulting your doctor first

4.  is morphine therapy for a copd person:  It's used occasionally to help COPD patients cope with air hunger.  It is a mild bronchodilator too.  Generally it's used for severe, end stage COPD.

5.  When does the therapist can give aerosol drugs for crying chi:  It does little good to give a treatment to a crying child because a smooth, laminar flow is required to get the best drug distribution.  A crying child also spends most of his (or her) time exhaling.

6.  symbicort for rescue inhaler:  What's the question?

7.  What brand of ventilator is commonly used today in hospital:  I work for a small town hospital, so what we use are collecting dust in larger hospitals.  I'm not really sure.  If any of my readers have an answer to this questions feel free to leave a comment below.

8.  symbicort vs advair:  The only difference I'm aware of is symbicort can be used as a rescue inhaler because it works fast to open up the lungs, while Advair takes a little longer.  The Symbicort SMART program is used in some countries but not in the U.S.

9.  how long can a patient be on BIPAP before needing intubation:  I'm assuming here you're referring to how long can a mask be on a patient, as in hours, days, weeks.  I believe the answer would be "it depends."  Is the patient tolerating it?  Is the patient able to come off it long enough to eat?  Is it working as you expect it to?  Does it look like the underlying condition is resolving? Ideally you'd want to use BiPAP in the hospital short term, just long enough for other medicines to fix the underlying condition.  If the underlying condition is not resolving itself, then perhaps you can continue therapy.  Does the patient want it?  Does the patient have a DNR or no vent order.  BiPAP may be your only option.  So, again, it depends.

Ideally, however, if a patient requires continuous ventilation you might be better off intubating the patient so you can control his breathing a little better.  Yet, still, you'll have to use common sense.

We did recently have a patient on BiPAP against his will, and the doctor even wrote an order:  "Do not remove mask from patient no matter what."  This I think is a bad idea.  The patient had complete whiteout on x-ray and could not ventilate or oxygenate even during short breaks from the mask.  Considering this patient wasn't getting adequate nutrition, and was highly anxious, I believed a better course would have been to intubate the patient.

Still, common sense is the best answer to this question.  We must do what is best for the patient without violating the patient's wishes, and not what is most convenient for us.