Would Bi-pap help?

Question

I have a girl 24 years old, shaken baby syndrome, in a vegetative state with tracheostomy, G/tube for drainage only, J/tube for feedings.  On 02 2L and cool mist at night.  She is blind. Have a pulse oximeter, sometimes sats drop to high 70's because of the copious secretions in the trach.  Sometimes has some sort of seizure activity during sleep and trach fills up quickly.  Some nights very restless.  Of course she requires much suctioning.  She has atelectesis in left lung and some in right also.  Would Bi-pap help her?  She gets frequent pneumonias from aspiration on her own secretions.  Would Bi-pap help keep the airway clear and help her rest better?  Please advise

Jenn12546 · Accepted Answer

Do they know if your daughter is retaining CO2? If that is the case, then maybe BiPAP or some ventilatory assist would be helpful....It sounds like her secretions are contributing to her restlessness, but maybe she isn't taking deep enough breathes and retaining CO2. The way to determine that is via an arterial blood gas, a pulse oximeter cannot give you those values, only oxygen saturation. 
One thing to consider is some form of chest physiotherapy, either manually or with a percussor to help move secretions from her lower lobes and out with suctioning. Of course, aggressive suctioning to keep her airway clear is also a good thing.
I am trached/vented (off during some hours of the day) due to a weak diaphragm and can tell you from personal experience that chest physio does wonders along with nebulizing hypertonic saline (much like sea water) and other meds to help thin my secretions. I also have CF, making my secretions sticky but that is another story. 
Does your daughter chronically culture bacteria? If she does, then perhaps prophylactic antibiotics would help. I chronically culture many bacteria and am on 2 forms of antibiotics every day to reduce the counts and hopefully, infections. 
I hope this helps you some, remember that what I say is from personal or professional experience and is not meant to replace your doctor's advice. Definitely talk to him or her before making any changes.
Good luck,

RRTDave · Answer

BiPAP would not be of benefit for your daughter. Suctioning and normal saline should be of great benefit. You could ask your health care professional about adding mucomyst nebulizer treatments to thin secretions.
Also, a good tracheostomy site: http://www.tracheostomy.com/

This page was dedicated to Aaron and has great information and tips.

Would Bi-pap help?

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