Oxylog 3000 NIV

GUIDE&FOR&NONAINVASIVE!VENTILATION& USING&THE&DRAEGER&OXYLOG&3000&PLUS& &

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• Please&perform&a&blood&gas&on&commencement& of&NIV&and&every&hour&after&settings&changed.& & • Check&the&medical&record&for&previous&NIV& pressures&if&available.&&When&interpreting&these& pressures,&please¬e&that&the&Oxylog&3000& uses&PEEP&&&Pinsp,¬&EPAP&&&IPAP.&& & &&&&&&&&& To&convert,&utilise&the&following& • PEEP&=&EPAP& • Pinsp&=&IPAPREPAP& & • A&properly&fitted&mask&is&as&important&as&the& settings&–&try&deflating&the&mask&to&improve&seal& and&comfort.&If&that&fails,&ask&the&respiratory& ward/ICU&for&help.&Please¬e,&if&mask&has& exhalation&valve,&the&Oxylog&wont&be&able&to& calculate&TV& &

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& Specific&patient&populations& # OBSTRUCED!LUNGS!(COPD/ASTHMA):!PEEP&should¬&exceed&10cmH2O.&Lower&Tinsp&to&achieve&I:E&ratio&>1:4.&Slope& should&be& (fast&inspiratory&flow&rate).&Check&medical&record&for&previous&NIV&pressures&if&available.&& # HYPERTENSIVE!APO:&Both&BPAP&and&CPAP&(BiPAP&with&Pinsp=0)&are&equally&effective.&Start&PEEP&at&10cmH2O&and&titrate& up&while&rapidly&titrating&highRdose&IV>N&to&patient’s&normal&blood&pressure.&IV&diuretic&if&patient&is&clinically&overload.& Avoid&NIV&if&patient&is&hypotensive&(cardiogenic&shock)& # ACUTE!INTERSTITIAL!OPACIFICATION!(MULTILOBAR!PNEUMONIA/ARDS):!NIV&unlikely&to&avoid&eventual&respiratory& failure&–&consider&intubation/palliation& # MORBID!OBESITY:!the&CPAP&settings&for&OSA&is&to&prevent&upper&airway&obstruction&and&higher&than&that&required&for& oxygenation/ventilation.&Likely&to&need&PEEP&>10&cmH2O&even&if¬&obstructing& &

Consider!intubation/!palliation!(i.e.!NIV!is!failing)!if! • FiO2!requirement!>60%!for!>2!hours! • Pmax!(IPAP&alarm)!>!25cm!H20! • RR!>!25!breaths!per!minute!despite!VT!of!8ml/kg!ideal!body!weight! • respiratory!acidosis!that!is!not!improving! • patient!is!tiring/!!GCS! !