2005 OPEN FORUM Abstracts
USE OF THE RESPIRONICS BIPAP VISION VENTILATORY SUPPORT SYSTEM FOR INTERMITTENT HIGH FLOW OXYGEN DELIVERY
Mark Siobal BS RRT, Ricardo Perez RRT, Audrey Hoebeke SRT, Respiratory Care Services, San Francisco General Hospital, UCSF Department of Anesthesia.
Background: The Respironics BiPAP Vision is often used to provide positive pressure ventilation with heated humidification either non-invasively via nasal or facemask, or invasively via an artificial airway such as a tracheostomy tube. During intermittent use, while the patient is off the device, high flow oxygen therapy with heated humidification is often required. A simple modification to the ventilator circuit allows the device to be used as a high flow oxygen delivery system and eliminates the need for an additional oxygen delivery and humidification device.
Method: With the device in the STD mode, IPAP and EPAP set to the same pressure, alarms for Low Pressure, Low Minute Ventilation, and Apnea disabled, and a pressure sensing line placed at the device outlet, the device delivers a constant flow rate at the approximate set FiO2 without any alarms. Laboratory testing of the system was performed using a Ventrak 1550 Respiratory Mechanics Workstation with the flow sensor positioned at the distal end of the circuit. FiO2 was measured with a calibrated oxygen analyzer positioned at the device outlet. Delivered flow rate and FiO2 at pressure settings of 4,5,6,7,8,9, and 10 cm H2O, and set FiO2 from 30 to 100 percent in 10 percent increments at each pressure setting were measured and recorded.
Results: The system delivered flow rates between 46 and 76 L/min at pressure settings between 4 and 10 cm H2O. FiO2 varied from set FiO2 by -2 to +8 percent (mean values ± standard deviation at all pressure settings of 28 ± 0.5, 37 ± 0.7, 55 ± 0.8, 65 ± 0.8, 75 ± 0.8, 89 ± 1.5, 97 ± 0.4, and 98 ± 0.7 percent with set FiO2 of 30,40,50,60,70,80,90, and 100 percent respectively).
Conclusion: High flow oxygen therapy with heated humidification and adjustable FiO2 can be delivered with this simple modification. Performance specifications of the brand of heated humidifier used should determine the continuous flow rate and humidifier settings necessary to optimize humidification.