My Dad is in Intensive Care on BIPAP for COPD, Should He be Having a Tracheostomy?

http://intensivecarehotline.com/?p=11734

My Dad is in Intensive Care on BIPAP for COPD, should he be having a tracheostomy?

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This question from Emma is from a 1:1 phone counselling and consulting session with me.

Hi Patrik,

my 87 year old Dad is currently in Intensive Care and has been for the last 4 days. He is on a BIPAP machine with a face mask for high CO2(Carbon dioxide) as he has been suffering from COPD for a few years now.

He has been in good health generally speaking and he has been living independently.

About 12 months ago he has had cardiac surgery for an Aortic valve replacement. He recovered fairly well from that given his age, however his COPD has been causing more and more trouble since.

He’s now at the point where he has been in hospital for about a month, initially two weeks in ICU, where he was on the breathing tube, ventilator and in an induced coma. He managed to get off the ventilator, he was discharged to the ward however, his CO2(Carbon doxide) kept climbing and he got readmitted back to Intensive Care 4 days ago.

As I mentioned, he’s now back on a face mask for BIPAP and they are managing to keep his CO2(Carbon dioxide) down that way.

His CO2 levels are climbing around 75 mmHg off the BIPAP.

He also as a lot of sputum at the moment that he can’t clear himself and the doctors are telling us with a tracheostomy it would be easier to manage the sputum as well.

The Intensive Care team has asked my Dad whether he wanted to have a tracheostomy, as they think that given his COPD and high CO2, he won’t manage to get off the ventilator with a normal breathing tube.

Continuation...
https://intensivecarehotline.com/questions/dad-intensive-care-bipap-copd-tracheostomy/