Duchenne Myopathy, Ventilation& Tracheostomy! Is BIPAP At Home Through Tracheostomy Reducing CO2?

https://intensivecareathome.com/duchenne-myopathy-ventilation-tracheostomy-is-bipap-bilevel-positive-airway-pressure-at-home-through-tracheostomy-reducing-co2-carbon-dioxide/

Duchenne Myopathy, Ventilation& Tracheostomy! Is BIPAP At Home Through Tracheostomy Reducing CO2?

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If you want to know if BIPAP (Bilevel Positive Airway Pressure) is an option for someone with a tracheostomy at home for hypercapnia, stay tuned! I’ve got news for you.

Hi, my name is Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies. We also provide tailor-made solutions for hospitals and intensive care units whilst providing quality care for long-term ventilated adults and children with tracheostomies, medically complex patients at home including Home TPN (Total Parenteral Nutrition), Home IV potassium infusions, Home BIPAP, Home CPAP (Continuous Positive Airway Pressure), as well as home tracheostomy care for adults and children that are not ventilated. We also provide IV antibiotics at home. We provide services at home for port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, as well as Hickman’s line management. We also provide services for palliative care at home. In essence, we are providing a genuine alternative for a long-term stay in intensive care and pediatric intensive care.

We have also sent, and we are sending our critical care nurses into the home for emergency department (ED) bypass services, and we have done so for the Western Sydney Local Area Health District as well as some aged care facilities to keep our clients out of ED and home.

Now, good day! I have a question from a reader who says, “Hi, Patrik. I have a family member at home with Duchenne myopathy with tracheostomy on mechanical ventilation, mainly due to hypercapnia.” Hypercapnia means high CO2 levels, high carbon dioxide levels. “Is it possible to connect him to a BIPAP device, a home device, through the tracheostomy and decrease CO2 levels?” Now, that’s a great question, and this question has come from Shirley.

That’s a great question, and the short answer to this is yes, you can do that, or you should be able to do that. You can’t really do it without getting a medical order for it.

I’ve worked in critical care for nearly 25 years in three different countries and I have worked with Intensive Care at Home obviously for 15 years on and off. So, from my extensive critical care nursing experience, absolutely that should be an option, but you cannot do that without getting a respiratory physician or an ICU consultant. Look at that and make the order, you can’t just do it without them checking CO2. You might need a sleep study for your family member. You might need some blood gases, or you can monitor the CO2 at home through a small connector and through your bedside monitor. So, there are ways of managing that, but you can’t really do it without medical order. But you also can’t really do it without having intensive care nurses 24 hours a day.

We have more and more families reaching out to us where we know they don’t have the help they need, which is where this question is coming from. They’re probably managing their loved ones at home. They don’t know what they don’t know. It is super, super risky. It is not evidence-based. And I can already see from your message, your family member is at high risk of sustaining a brain injury, of going back to ICU if you’re not managing CO2 correctly. But I want you to reach out to us.

Continue reading at: https://intensivecareathome.com/duchenne-myopathy-ventilation-tracheostomy-is-bipap-bilevel-positive-airway-pressure-at-home-through-tracheostomy-reducing-co2-carbon-dioxide/