6. Ventilatory Support Flashcards
Sx of OSA
Snoring framed by breathing pauses
Excessive daytime sleepiness ( maybe even during driving)
Ix of OSA
Home sleep study- AHI
Only consider polysomnography of unclear or no high AHI index
WHat is needed for Dx of OSA
- 15 apnoeas → desaturation of more than 4%
- If less than 15 can do polysomnography
What diseases is sleep apnoea assoc with
- Assoc with hear disease/ CV disease
- cognitive impairment
- RTA
when is CPAP used and when is BIPAP used
CPAP for OSA, BIPAP for acute TIIRF and COPD exacerbations
When can domicillary NIV be given
- if have chronic respiratoru hypercapnoea
- 2 levels of pressure delivered
- Designed to reverse TIIRF by increasing ventilation
- Chronic TIIRF eg.. NM failure, MND etc
Which pts can be given LTOT
- For chronic hypoxaema
- PaO2 < 7.3, checked x2 3 weeks apart, 6 weeks since exacerbatn
- Slow progression of pulm HTN, decrease in mortality
When should pneumonia patients be admitted or sent to ICU
3 or more
What is target SPo2 for acutely unwell pts ( both scales)
94-98% vs 88-92 if risk of chronic hypercapnoea
When should venturi mask be given
If target 88-92 or unwell with type I
oxygen range from venturi
Fio2 24-60%
Define RF
- PaO2 < 8kPa * breathing air
- or PaCo2 >6.5 kPa
Possible compensation for hypoxia
Mild resp alkalosis due to blowing off Co2
If pt is hypercapnic and Pa02>8, is this RF
yes
pH in chronic TIIRF
may be normal due to raised bicarb to compensate for resp acidosis
Primary resp acidosis with sec metabolic alkalosis???