Using CPAP & inhalation to treat patient with acute asth

[hasanj]

Hi, would you feedback with ideas to treat patients with acute asthma by using Cpap & inhalation together?

Thank you

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[Martin345]

by inhalation do you mean nebulised normal saline?

if so, it probably won't work because of the very high flow rates at which most cpap machines operate

[hasanj]

Hi .I mean inhilation with ventolin ,during cpap (the cpap has special conectin for nubolizer which allow un to give both cpap and inhilation therapy

[Martin345]

i guess you could look at how quickly the solution is nebulised. you know it should normally take several minutes (depends on the volume of course).

thus, if it takes much less than this then it is probably being nebulised too quickly because of too high a flow rate, and therefore won't really be effective because the particle size will be too high or too low (i don't know the specifics of this).

that's all my guesswork though based on my experience and things others have told me over the years - i don't know for sure. if you find out more, let me know.

[shane246]

Further to Martin's comments, I guess it would depend on which type of CPAP set up you are using. Some CPAP units have attachments that allow MDIs to be inserted/used as required. Alternatively, as Martin suggests there is the possibility of inserting traditional nebuliser units into the CPAP circuitry, although flow rates, particle size, deposition etc are all issues to contemplate. At the ICU/ high dependency end of the spectrum there are numerous new generation ventilators that allow 'smart' nebulisation (on inspiration only to avoid wastage) during CPAP (whether delivered invasive or non-invasive) - these can be set up via infusion pumps to allow almost continuous nebs to be delivered, which can be very effective and useful in the very acute asthmatic.
Perhaps hasanj you could describe the equipment (manufacturer, model etc) to help guide our thoughts and input if we have experiences with similar equipment?
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