High Leak with Bipap on Trach

[luvkher]

Hi,
My Son is having a trach (uncuffed) and is on Bipap 24/7 with setting of Ipap/Epap of 11/5. Used with Heated Humidifier

He had cuffed one earlier but since about 1 month he has uncuffed.
initially he had leak of 3 to 5 L.
today i saw leak of 35 L.

over last weeks, his leaks have increased steadily, i.e. from 3 L to today.
since last week it has jumped from 20L to 35L

can someone guide,
1. does it effect lungs adversely. ? we have seen dryness, so neubulize him with saline every 5/6 hrs
2. Any other effects that we should be worried about?

Thanks
Kind Regards

[vsheline]

Hi,
My Son is having a trach (uncuffed) and is on Bipap 24/7 with setting of Ipap/Epap of 11/5. Used with Heated Humidifier

He had cuffed one earlier but since about 1 month he has uncuffed.
initially he had leak of 3 to 5 L.
today i saw leak of 35 L.

over last weeks, his leaks have increased steadily, i.e. from 3 L to today.
since last week it has jumped from 20L to 35L

can someone guide,
1. does it effect lungs adversely. ? we have seen dryness, so neubulize him with saline every 5/6 hrs
2. Any other effects that we should be worried about?

Thanks
Kind Regards

Hi luvkher,

Your profile says you are not using software, so I suppose you are using an on screen Info menu of some kind?

I am familiar with the standard S9 VPAP units for sleep apnea, but I am not familiar with the ResMed ventilator products like the Stellar 100 or Stellar 150 or Astral 150.

On my S9 VPAP model, which looks just like the S9 AutoSet, we enter the Advanced Info Menu by holding down both rectangular buttons at the same time, for about 4 seconds. Then by turning the round knob we can navigate to Sleep Report, and then by pushing on the knob we can enter the Sleep Report, and then by turning the knob (if needed) we can highlight Period, and by pushing on the knob we can enter Period edit mode, and by turning the knob we can change the period to 1 day, and by pushing the knob we can save the Period. Then we can turn the knob to navagate to Leak. This shows the median Leak during the period selected.

I don't know what you should do, but if the median Leak is 35 Liter per minute, I think that may be a potentially serious problem.

I think up to 24 L/min Leak may be okay when using a mask; I think over 30 may be large leak which may be degrading the accuracy of the machine to some degree, when using a mask.

But I really don't know whether the Leak amounts which are okay for mask delivery would also be okay for trach delivery.

If your son's trach is leaking 35L/min then I would wonder where is it leaking, and would wonder if the leaking is causing irritation somewhere.

Also, when the Leak gets too high, at some point the humidifier may be unable to properly humidify the air, perhaps leading to severe dryness.

Sorry to cause alarm, but I recommend contacting your doctor or other medical professional at once. Maybe your insurance company or hospital has a 24 hr medical questions hot line to call?

Take care,
--- Vaughn

[luvkher]

Thanks Vaughn,
we are using now infact using a Resmed S8 Vpap ST, which has a different humidifier, got this as the S9 was not providing adequate humidification to the trach.

the S8 with H4i prvoides a better humidifcation.

on the leak, this is also a big concern for us , more so we have seen this now to increase substantially in last weeks. The Doctors here are not giving it a concern, saying the leak is fine as its uncuffed. nor do we have any medical hotline in my country to answer these queries. !!!

is there a pulmonologist who expertises in Trach that i can contact online?

Thanks
Kind Regards

Luv