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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today, I have a question from Frank who says, “How long does it take for BIPAP to lower high carbon dioxide or high CO2? My mom has been in intensive care for the last two days for high CO2. She’s got asthma and COPD. So, I really want to know how long will it take for a BIPAP to help with high CO2?” So, what a great question, Frank.

After having worked in intensive care for over 20 years in three different countries, I can tell you that it really depends. I have seen patients coming in with high CO2, high carbon dioxide with asthma COPD (Chronic Obstructive Pulmonary Disease), and then you put patients on BIPAP (Bi-level Positive Airway Pressure).

You put an arterial line in and then you do an arterial blood gas and high CO2s (Carbon Dioxide) can go from 70 mmHg down to 50, less than 45 within no time within a few hours, or sometimes you need to adjust the BIPAP over a number of days. You need to see how much BIPAP is working, for example, is a PEEP of 5 with a pressure support of 10 above 5 working? Do you need to go higher with PEEP (Positive End-Expiratory Pressure) and pressure support? So, I don’t want to get too technical here but at the end of the day, you might have to adjust the BIPAP to get the CO2 down and there might be a little bit of trial and error.

It also depends on whether, in intensive care, you need to start somewhere on opiates or on sedatives when they’re on BIPAP, even though we should try and avoid it because opiates, in particular, have respiratory depression as a side effect. Therefore, CO2 can rise as part of the side effect. So, keep all of that in mind when looking for how long will it take for the BIPAP to lower your mom’s PCO2 (Partial Pressure of Carbon Dioxide) or carbon dioxide for asthma and COPD.

Other things that come into play are conscious level, is your mom awake? Is she drowsy? Again, is she getting mild sedatives or opiates? Ideally not, hopefully she can tolerate the BIPAP without needing sedatives or opiates. But those are all part of how long it will take for the BIPAP to get the CO2 or carbon dioxide down.

Some of it will also depend on whether your mom can get mobilized and whether she can get out of bed because if someone is lying in bed all day, they’re not sitting up, they can’t expand their breathing muscles. That also means they might have difficulties exhaling or breathing out the carbon dioxide. So, those are all factors that impact on how long it will take for BIPAP to lower PCO2 or carbon dioxide.

Last but not least, it is important that CO2 can be lowered when using BIPAP because otherwise, the risk that a patient or your mom in this situation might need intubation or might need put on a ventilator with the breathing tube is pretty high. So, therefore, it is critical that CO2 is coming down.

Another reason why CO2 needs to come down is if you’re not getting CO2 down to a level of 35 to 45 mmHg, your mom or patients can get drowsy. Too much carbon dioxide simply makes people drowsy and sleepy. Again, that is a risk for your mom or for any patient to need intubation and being put on a ventilator with a breathing tube, that’s what the BIPAP should prevent. So, keep all of that in mind.

So, that is my quick tip for today.

We have a membership for families of critically ill patients in intensive care if you go to intensivecarehotline.com and if you click on the membership link or you go to intensivecaresupport.org directly. In our membership, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions, intensive care related.

I also offer one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I talk to doctors and nurses directly. I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one in intensive care so that you can make informed decisions, and have peace of mind, control, power, and influence.

I have worked in intensive care for over 20 years in three different countries where I also worked as a nurse unit manager for over 5 years and I have been consulting and advocating for families in intensive care for the last 10 years at intensivecarehotline.com. I recommend you have a look at our testimonial section as well as our podcast section so you can see what our clients say. We have saved lives. I can say that without any hint of exaggeration that we have saved lives as part of our consulting advocacy because we understand intensive care inside out and we are strong advocates. We know the ins and outs of intensive care. We know about patient and family rights in intensive care.

Now, I also represent you in family meetings with intensive care teams, so once again, so that you make informed decisions, have peace of mind, control, power, and influence, but more importantly, so that you get better outcomes and better care and treatment for your loved one.

Also, you need to have a strategy when you go to family meetings with intensive care teams. 99.9% of families in intensive care have no strategies whatsoever. I’ll make sure you don’t get walked all over and I strategize with you whether you even should go into a family meeting.

We also offer medical record reviews in real-time so that you can have a second opinion in real-time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.

Also, if you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next and what questions and insights you have.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.