Hypercapnia and 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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Hypercapnia and BiPAP

Postby curiousgeorge » Mon Dec 07, 2015 1:53 am

XXX is in the hospital and has a high CO2 level (80). The pulmonologist is looking at changing XXX’s BiPAP settings. Do you have any insight on how to properly decrease CO2 levels?

(Asked by a family member)

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bachjr
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Re: Hypercapnia and BiPAP

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

He should not be using bi-level PAP in the first place. With CO2 that high he is also probably receiving oxygen! Get him off O2 and on a portable ventilator with an active circuit and 15-mm angled mouthpiece on CMV mode (assist/control) volume 800-1500 ml and backup rate of 12 breaths/min and tell him to keep his O2 sat over 94% by getting deep breaths via the mouthpiece. Use the same settings for sleep nasal ventilation.

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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