Mom's in ICU on BIPAP with CO2 level 55&she's lethargic&sleeping all the time. Wakes up occasionally

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-moms-in-icu-on-bipap-bilevel-positive-airway-pressure-with-co2-carbon-dioxide-level-of-55-shes-lethargic-sleeping-all-the-time-wakes-up-occasiona/

Quick Tip for Families i ICU: My Mom is in ICU on BIPAP and her co2 level is 55 and she is lethargic and sleeping all of the time. Wakes up occasionally when spoken to

Book your free 15 minute phone consultation here

http://intensivecarehotline.com/scheduling-appointment/

Call directly 24/7

+1 415-915-0090 USA/Canada

+44 118 324 3018 UK

+6141 094 2230 Australia

Email support@intensivecarehotline.com

Get 1:1 consulting and advocacy

1:1 phone counselling

http://intensivecarehotline.com/one-on-one-counselling/

Become a member for families of critically ill Patients in Intensive Care

https://intensivecarehotline.com/intensivecaresupport-org-membership/

Immediate action steps http://intensivecarehotline.com/take-control-take-charge/immediate-action-steps/
https://intensivecareathome.com
And if you need a medical record review , click on the link and we can help you with reviewing your loved one’s medical records while they’re in ICU.
https://intensivecarehotline.thrivecart.com/review-of-medical-records/

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

So, today’s tip is answering a question from another reader who says, “My mom is in ICU and BIPAP (bilevel positive airway pressure) and her CO2 (carbon dioxide) level is 55. And she’s lethargic and sleeping all of the time. She wakes up occasionally when spoken to. What should I be looking out for, especially in view of getting rid of the BIPAP?” Well, that’s a fantastic question and I’m glad you’re asking it.

So, when patients are in ICU on BiPAP, it’s often a sign of respiratory failure or it can be a sign of Type 2 respiratory failure. So, Type 1 respiratory failure is low oxygen levels and Type 2 respiratory failure is high CO2 levels. And it sounds like your mom might have type two respiratory failure of unknown cause. You haven’t shared whether she’s got a history of COPD (chronic obstructive pulmonary disease), whether she’s got history of asthma, whether maybe she overdosed on some opiates. You haven’t shared any of that.

But the reality is that if CO2 levels are high around 55 millimeter per mercury that she might be drowsy. Normal CO2 levels are 35 to 45 millimeter per mercury, and 55 is too high. Some patients with COPD or asthma have a high baseline, i.e., their CO2 level is higher to begin with. They might start their baseline CO2 might be around 50 but given that your mom is sleepy, she probably has a normal CO2 baseline.

The other thing that you got to look out for is, is she on opiates such as morphine, fentanyl? Is she having any other sedatives? Is that potentially a reason for her sleepiness? Because if she has a high baseline CO2, it could as well be the medications that she’s getting that’s making her sleepy because her CO2 might be high to begin with. Those are questions you should be asking.

Now, other things to get CO2 down, let’s assume your mom doesn’t have a high baseline CO2. Let’s just say your mom’s CO2 baseline is normal. Why is it so high? You should be looking out for how much BIPAP are they giving her. What’s her PEEP (positive end expiratory pressure)? What’s her pressure support? And if CO2 is too high, maybe they need to increase PEEP and pressure support to get CO2 down. But also, as I said, maybe they need to stop any opiates that she may or may not be getting. Any sedatives that she may or may not be getting.

So, other things that should happen if your mom is awake is physical therapy or physiotherapy and breathing exercises. Ideally, mobilization should happen. Other things you need to look out for when someone is on BIPAP is aspiration risk. So, if your mom is drowsy, she might have a nasogastric tube to get feeds and nutrition through the nasogastric tube and if she’s drowsy, there’s definitely an aspiration risk as well. Now, the last thing that you want for your mom is that she’s aspirating when she’s on BIPAP because the next step there is often that patients are going to be intubated or have the breathing tube inserted and be put on a ventilator and go into an induced coma. And that is not what you would want for your mom.

Continue reading at: https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-moms-in-icu-on-bipap-bilevel-positive-airway-pressure-with-co2-carbon-dioxide-level-of-55-shes-lethargic-sleeping-all-the-time-wakes-up-occasiona/