A patient with central sleep apnea uses a nasal mask with NIV at ...

[KimWrice]

A patient with central sleep apnea uses a nasal mask with NIV at night. The patient complains of nasal congestion. What action should the respiratory therapist take?
 
  a. Reduce the EPAP.
  b. Add a heated humidifier.
  c. Switch to a mouthpiece.
  d. Add a heat/moisture exchanger.

Question 2

What determines the patient's delivered tidal volume in all modes of bilevel positive-pressure ventilation?
 
  a. IPAP
  b. EPAP
  c. The gradient between the IPAP and EPAP
  d. Patient's respiratory rate

[efwsefaw]

Answer to Question 1

ANS: B
NIV can cause excessive drying of the nasal mucosa, which has been associated with nasal con-gestion and increased nasal resistance. A heated humidifier can significantly reduce the dryness that causes congestion. Use of an HME is inappropriate, because it would lead to increased WOB.

Answer to Question 2

ANS: C
In all modes of bilevel positive-pressure ventilation, the patient's delivered VT depends on the gradient between the IPAP and EPAP, the inspiratory time, and the patient's inspiratory effort and lung characteristics.

[KimWrice]

Excellent

[chereeb]

Gracias!