Bilevel CPAP

[nashwa]

I know initial setting is 8/5 mmHg Th 1sec and RR 20, my question is if there is co2 retention or still there is subcost retraction... What should we do increase pr or increase delta p or rate???

 

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[nashwa]

????

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[bimalc]

On 3/1/2019 at 8:50 AM, nashwa said:

 

I know initial setting is 8/5 mmHg Th 1sec and RR 20, my question is if there is co2 retention or still there is subcost retraction... What should we do increase pr or increase delta p or rate???

 

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The important thing is WHY you think these things are happening.  If the patient is over breathing (and they presumably are at a RR 20) and they are generating some reasonable tidal volume natively, changing the rate is unlikely to help CO2 retention (though it might help work of breathing/retractions), similarly if you think the patient cannot natively generate sufficient tidal volume then increasing delta P and/or RR may be reasonable.  Finally, recall that the single most important goal of respiratory support, especially early in life, is maintenance of functional residual capacity.  If you think you are in respiratory failure because you are losing FRC, you need to re-recruit and increase PEEP (and possibly MAP more generally) to try and maintain FRC.