- New Member
- Posts: 2
- Joined: Sun Feb 28, 2016 7:21 pm
- Diagnosis: SMA 2
- Diagnosed: 2006
- State or Province: California
He has never had to go to the hospital as we have always managed his illnesses with the use of MIE & The Vest at home.
He has never been on BiPap yet after this event and learning from the BreatheNVS website we will be putting a better program in place at home and that will hopefully include IPPV or at the least BiPap with the lowest EPAP settings.
He has been intubated for 12 days now and his X-rays of the lungs are getting clear.
The ventilator is set at :
16 cmH20 Inspiratory press.
8 cmH20 PEEP
At these settings and awake he has readings of :
entCO2-----38-58 ( most of the awake hours are 45-58)
At these settings and asleep he has readings of :
Any thoughts on the Vent settings ?
They look to be to high in the BPM and the Inspir. Press seems too low and PEEP seems too high.
I asked the Dr. here if we could start to lower the PEEP and raise the Insp. Press. & get closer to an 18 cmH20 difference between PEEP & Insp. Press. with hopes of lowering his etCO2.
Needless to say, he did not like this idea & instead is considering giving another diuretic ( he was already given 1 dose of Diamox and that did nothing) to try to get rid of the excess CO2.
We are in a hospital with Dr.'s that are listening to the care and extubation protocols of BreathNVS yet they are reluctant to put them all in place.
We are very happy that a few RT's at this hospital are familiar with using MIE while intubated as that has proven to be crucial.
We normally use MIE settings at home, using a mask, of +40 to 55 for 2 sec then -40 to 55 for 2 sec & pause for 2 sec.
While Intubated at the PICU we are using +30 for 1.5 sec then -30 for 1.5 sec & pause for 1.5 sec.
He suffered a minor pneumothorax during our stay at a previous hospitals PICU. This may have happened because the staff there did not know how to use the MIE while intubated and neither did we.
The chest tube was removed 3 days ago.
Knowing this information about the pneumothorax
Are these settings sufficient ?
He is still on Fentanyl & Versed for pain.
The Intubation tube is wearing away at his teeth and roof of his mouth and he is ready to get the tube out.
Any thoughts on how to get out of this situation ?
Any help is very greatly appreciated
- Medical Director
- Posts: 135
- Joined: Wed Nov 11, 2015 3:07 pm
- City: Newark
- State or Province: NJ
- Country: USA
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
Who is online
Users browsing this forum: No registered users and 1 guest