Settings while intubated

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ColtonSMA
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Settings while intubated

Postby ColtonSMA » Fri Mar 04, 2016 1:45 pm

My son 13 months type 1 SMA. Is currently intubated and has been for about 36 hours. He is on no o2. And settings are 18/6 rate of 20. From my understanding these settings are no correct and he should be on a rate of 30. Doctors here who are not SMA friendly think he should be doing all the work and want to slowly make him do all the work. I need help and advice on what his settings should be while intubated his current Bipap settings before intubation is 18/5 back up rate of 30.

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bachjr
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Re: Settings while intubated

Postby bachjr » Sun Mar 06, 2016 12:03 am

The settings should be whatever keeps him in synchrony with the machine and the CO2 and O2 sat normal without him receiving any oxygen. When a child breathes very quickly they should usually be about 1/2 of the rate to capture every other breath. He should essentially be doing NONE of the work while using the machine because his breathing muscle should be rested then. Generally the EPAP should be off because it does not help. For that reason we do not use BiPAP but pressure preset ventilation.
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

ColtonSMA
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Re: Settings while intubated

Postby ColtonSMA » Mon Mar 07, 2016 1:22 pm

They have changed his settings back to 18/6 on the vent with a rate of 18. Triggering the breaths. His o2 sat and co2 have been normal. Coltons left lung is still down and has been for four days we are working hard to get it popped back open but having a hard time

ColtonSMA
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Re: Settings while intubated

Postby ColtonSMA » Tue Mar 08, 2016 8:25 am

Dr Bach, we seen you back in October. Have you been notified about Colton and his settings they have him doing some of the work and they will no understand or listen to me I need to have them contact you. His rate on the vent is 18. That just isn't enough support I believe. These doctors do not know SMA and what is best. I really do need your help.

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michaelchiou
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Re: Settings while intubated

Postby michaelchiou » Tue Mar 08, 2016 12:20 pm

Hello,

Unfortunately, this situation happens too often. And you are not alone.

We often recommend that patients strongly urge their physicians to contact Dr. Bach or you must have Colton transferred to our hospital. Dr. Bach has emailed to you information. Please let us know if you have not received it. Also, we hope you will keep us updated on Colton.

Best wishes,
Michael Chiou
Michael Chiou
Operations Director, VentilaMed BreatheNVS


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