biPAP

Please use this forum for any general discussions or questions you have about noninvasive ventilatory support and mechanical insufflation-exsufflation (MIE).
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curiousgeorge
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biPAP

Postby curiousgeorge » Mon Dec 07, 2015 1:52 am

What mode should my 18-year-old son be on using the Trilogy? The respiratory therapist has him on his same settings as his old AVAPs (Respironics BiPAP). He has only used his new Trilogy for five nights. He says it seems like he needs more pressure on the IPAP. Does the Trilogy setting run a little higher or lower than regular BiPAPs? The SMA support group says he should only be on pressure control mode or ST (back-up rate) mode and that AVAPs aren't good. What are your thoughts?

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Last edited by curiousgeorge on Thu Mar 17, 2016 12:15 pm, edited 1 time in total.

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bachjr
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Re: biPAP

Postby bachjr » Mon Dec 07, 2015 1:55 am

The SMA support group is almost correct. You cannot air stack or get deep insufflations (“sighs”) using bi-level PAP, so his lungs will not grow and will become stiff. He should be using the Trilogy with an active circuit (not passive “BiPAP” circuit) on volume control at 700-1400 mL volumes, but most respiratory therapists have no understanding or experience with this and even when they switch patients from BiPAP units to the Trilogy, they use the Trilogy on bi-level PAP mode with the same passive ventilator circuit.

JB
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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