Return VT on BIPap DURING POSITIONAL CHANGES. Charlotte Burns, SRT Robyn Borkowski , SRT Kimberly Sizemore, SRT Shawn Thomas, SRT Claire Washington, SRT Support and equipment was provided by Lone Star- Kingwood College Respiratory Dept. . Hypothesis.
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Charlotte Burns, SRT
Robyn Borkowski, SRT
Kimberly Sizemore, SRT
Shawn Thomas, SRT
Claire Washington, SRT
Support and equipment was provided by
Lone Star- Kingwood College
We hypothesize that patient positioning does in fact play a vital role in the delivery of tidal volumes during bi-level positive airway pressure.
Will changes in body position affect the return VT on a healthy adult getting BiPAP?
Patient positioning plays a vital role in the success of NIPPV. Current guidelines indicate that the patient should be in an upright sitting position, or lying down in the supine position with the head of the bed (HOB) elevated 30 degrees or greater. Slouching is discouraged because it impairs diaphragmatic movement, and results in decreased inspired tidal volumes.
Non invasive positive pressure ventilation (NPPV) is now a common device used in hospitals and home care facilities on a daily basis. According to Mosby's Respiratory Care Equipment "the first successful use of non invasive positive pressure ventilation (NPPV) was recorded as early as the mid eighteenth century." (Cairo, pg 773).
In the 1940's Motley and colleagues at Belleuve hospital studied the use of NPPV on patients with pneumonia, pulmonary edema, near drowning, Guillain Barre syndrome, and acute severe asthma. In the 1960's PEEP was used in the treatment of acuter respiratory distress syndrome (ARDS). By the 1970's care givers were able to understand the effects on invasive ventilation and the lung damage it can cause, so researchers went back to NPPV.
In the 1980's NPPV became widespread and many different brands and modes were developed. In 1987 one study showed the successful use of NPPV in three patients with post infection muscle weakness and two with muscular dystrophy. This demonstrated that NPPV could be used and effective in long term settings and diagnosis. In 1989 Meduri and colleagues were successful in avoiding intubations with the use of NPPV in eight out of ten patients.
The BIPAP is intended to be used with special masks or connectors that have exhalation ports to allow continuous flow of air out of the mask. When the device is turned on and functioning properly, new airs from the device flushes the exhaled air out through the mask exhalation port. However, when the device is not operating, enough fresh air will not be provided through the mask, and exhaled air may be re-breathed. Re-breathing of exhaled air for longer than several minutes can in some circumstances lead to suffocation.
semi-fowler position =675
New biological questions: It would be nice to see this test done on:
The differences between the test subjects’ tidal volumes were not significant in the positional changes, therefore we conclude that moving the patients’ positions had no benefit on the return tidal volume of healthy awake individuals.
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