DMD patient using sip technology

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curiousgeorge
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DMD patient using sip technology

Postby curiousgeorge » Sun Nov 13, 2016 2:27 pm

I am keen to provide mouthpiece ventilation (MPV) for a DMD patient. I have tried and failed to get him using the ‘sip’ technology provided by Phillips simply because the patient cannot coordinate the ‘sip’ followed by an inspiration. I imagine that you have significant experience of using MPV, in a triggered mode using active exhalation, negating the need for PEEP, without back-up rate. I assume this would eliminate the need to coordinate and the patient could just breath in through the mouth piece to trigger the breath. I have sought advice from colleagues in the UK but they don’t seem to be able to help, would you be willing to provide me with some advice.

A long shot I know but both the patient and myself are keen to get him established on MPV to improve his day time ventilation and quality of life.

(Asked by a provider)

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bachjr
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Re: DMD patient using sip technology

Postby bachjr » Sun Nov 13, 2016 2:28 pm

Last edited by bachjr on Sun Nov 13, 2016 2:30 pm, edited 1 time in total.
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School

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curiousgeorge
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Re: DMD patient using sip technology

Postby curiousgeorge » Sun Nov 13, 2016 2:29 pm

I think it might well be that nasal leakage and mouth seal are an issue although a nose clip didn’t seem to help. The problem with the ‘tongue touch’ is that after the touch he then struggles to coordinate an inspiration, presumably the leakage from lips and nose contribute to this. I will try him with the AMBU Bag and see what happens.

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bachjr
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Re: DMD patient using sip technology

Postby bachjr » Sun Nov 13, 2016 2:29 pm

John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School

Noninvasive
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Re: DMD patient using sip technology

Postby Noninvasive » Sat Dec 31, 2016 2:26 am

Hello, is there a way to teach somebody how to "seal" their nasopharyngeal during mouthpiece ventilation?

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bachjr
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Re: DMD patient using sip technology

Postby bachjr » Mon May 15, 2017 4:29 pm

It sounds like the machine's sensitivity is too low. It should be no problem to get a deep breath from a mouth piece. Also, there should be no "PEEP" or "EPAP".
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School


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