Most standard hospital volume respirators are designed to deliver and assess ventilation in a closed system, including tracheostomy or intubation tube cuff inflation. Only portable ventilators are currently adequate for TIPPV with cuffs deflated or removed. Further, most if not all current nursing and respiratory therapy school curricula emphasize the need for closed systems and [...]
Ninety-one of the 104 patients converted from TIPPV with an inflated cuff to either a deflated cuff (28 patients) or no cuff (63 patients). These patients remained dependent on TIPPV in this manner for an average of 4.2 years (range, one week to 29 years), including 23 patients for nine years or more. Ten of [...]
All of the vital capacities (VCs) of the patients were measured in both sitting and supine positions. Any patients for whom food aspiration was suspected had methylene blue tests. Two patients with positive methylene blue tests had high positioned tracheostomies and were converted to noninvasive alternatives of ventilatory support without long-term cuff deflation. Two other [...]
One hundred four long-term ventilator-dependent patients with neuromuscular respirator) insufficiency were referred for pulmonary rehabilitation. Seventy-eight of these patients were dependent on TIPPV with inflated cuffs at referral. The other 26 patients were converted to TIPPV after varying periods of time receiving noninvasive methods of assisted ventilation. The 104 patients presented with the following diagnoses: [...]
Patients with traumatic quadriplegia or progressive neuromuscular conditions may require long-term ventilatory support that is most frequently managed by intubation and subsequent tracheostomy and tracheostomy intermittent positive pressure ventilation (TIPPV) with an inflated cuff. Patients are often unnecessarily maintained with an inflated cuff longer than necessary. Although cuff deflation and transition to the use of [...]
The dE( +) with HMEs was different from that with HWBs. Although dE( +) with HWBs was theoretically zero, it was not actually zero, probably due to delay in expiratory valve opening. The Bear 5 monitors the inspiratory flow rate, and a decrease to one fourth of the peak inspiratory flow rate is the criterion [...]
There are various humidifying devices and their ability to heat and humidify has been evaluated extensively. Unfortunately, all humidifiers exhibit airway flow impedance and this flow resistance against continuous flow also has been evaluated. Their flow impedance sometimes causes malfunctioning of the low pressure alarm which detects a ventilator disconnection. Little attention, however, has been [...]
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