Qualifying Patients for Noninvasive Positive Pressure Ventilation Devices on Hospital Discharge.
When and how do I qualify inpatients with acute on chronic hypercapnic respiratory failure for home noninvasive positive-pressure ventilation at the time of discharge? A 44-year-old woman with morbid obesity (BMI, 48) was brought to the hospital by her boyfriend for 1 day of confusion and reduced alertness. She had a history of chronic dyspnea on exertion and 10-pack-years of smoking. She also had history of well-treated diabetes and hypertension. In the ER, she was found to be somnolent but arousable and following commands appropriately. Her oxygen saturation was 86% on room air, and arterial blood gases indicated a pH of 7.16 with a Paco2 of 87 mm Hg, a Pao2 of 60 mm Hg, and a bicarbonate of 42 mEq/L. Chest radiograph showed mild pulmonary vascular congestion. She was started on continuous bilevel positive airway pressure and medical therapy, with clinical improvement.
Duke Scholars
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Related Subject Headings
- Respiratory System
- Respiratory Insufficiency
- Positive-Pressure Respiration
- Patient Selection
- Patient Discharge Summaries
- Patient Discharge
- Patient Acuity
- Noninvasive Ventilation
- Humans
- Home Care Services
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Respiratory System
- Respiratory Insufficiency
- Positive-Pressure Respiration
- Patient Selection
- Patient Discharge Summaries
- Patient Discharge
- Patient Acuity
- Noninvasive Ventilation
- Humans
- Home Care Services