Respiratory Therapy - Airvo vs Salter HFNC

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[BarryDenton]

Love the Airvo, but the new work place uses the Salter NC a lot. You nailed it for me! I had a discussion with a doctor today explaining my thoughts on both devices. Guessing, I explained using the Airvo to increase the patients PaO2 /SpO2 and decreasing the patients WOB & CO2. While only increasing the SpO2 / PaO2 with the Salter HFNC. Also, I added the Salter NC may be a great option for a moderate pneumonia patient that has a low O2 issue. Of course, I threw this answer straight from my butt! I have never used a Salter NC. I'm glad that I didn't look like a straight dummy! Thanks for the quick response and video. You're pretty damn smart, Joe! Thanks, buddy!

[rtclinic]

Great comparison! Very relevant for many clinicians. I share your sentiments regarding accurate PF ratios.

[ValentinanSantinamommy]

Airvo is better warm humidification the salter is cool. Great for Covid patients but we put them on the salter target FIo2 88 and greater. Some do well some don’t their saturation drops at 15 liters so we move them to icu to put them on the airvo. Since covid we use the salter without humidification.Some do well and get better and others end up Intubated.

[greensahuaro]

That's why we should welcome back IPB B as a demand pressure support to decrease WOB and can be used with a blender. IPPB will be more comfortable than continuous flow if BIPAP, especially with those full face masks that cover the person's eyes. Most alert people can't tolerate BIAP because of the continuous flow. A Sri gvloaded PPEEP valve can be placed on the exhalation side of the IPPB circuit! As a fact, one way valve can be placed on both inspiratory side and expiration side of the circuit. Humidiry can be implemented with a servo system! A tacho.eter or volume devise can be placed on exhalation end side of circuit! A PEG tube ought to be placed on patients who easily desats. But it will on demand breat which is more comfortable and tolerable than continuous flow from CPAP OR BIPAP! A pressure gauge can be place in the circuit and an apnea alarm! It's actually NIPV in a pneumatic way! A Wright respirometer can be used as well!
I've done sleep studies and RT, it appears that patients tolerate the face masks that don't cover the eyes better! It's more independent dent! Or, if flows are not too high and pt is cooperative, a nasal CPAP Mask, humidity, , with a chin strap can be used so the person can eat!
Best regards, Carlos

[ventilator]

These are GREAT for trach patients. When you have a trach patient who's working to get off the ventilator, I've seen so many people put them on COOL MIST!!!! For your trach patient, COOL MIST SUCKS!!! It's uncomfortable. In the home patients, they get these horibly loud compressors, which are so loud, they are disturbing, and hard to get use to. If you have a trach patient, THEY NEED WARM HUMIDIFIED AIR/OXYGEN!!! The AIRVO is PERFECT for them. They don't have that gross cold water filled with bacteria sloshing around in the tubing, and in a water trap at the bottom of the circuitry.

[angelacurro]

Hey Joe, Airvo is being used now in LTC, can there oxygen source be a concentrator? I have gotten both answers!

[greensahuaro]

I say bring IPPB back electronically so we can give pressure demand ventilation without the uncomfortable continuos flow of CPAP AND BIPAP, that most alert patients don't tolerate. Also controlling Itime, flow, and adding g humidity. I noticed that during the pandemic I worked for institutions that were using BIPAP xontinuously with no hinidity. With 100% oxygen and no humidity that drys the membrane and with 100% oxygen it creates oxygen toxicity. What are they doing? Pressure demand becomes sort I'd a pressure support either nasalky or full face mask and to co.pare just flow, it should decrease work of breathing for that esoecificbpopulation in respiratory distress! Thanks!

[greensahuaro]

I was thought of school that the lungs need to be wet for the membrane to work.
During the pandemic I found people In BIPAP continuos with high oxygen and no humidity. That is wrong. That drys the airways the membrane and gases don't diffuse easily and high oxygen can cause toxicity. There has to be humidity for the membrane to work!

What do you thinkg about placing an HME between the BIPAP circuit and the mask?

[teedubya]

can you use the salter HFNC at flows < 6 LPM. say for a patient that may need 2 LPM at rest, but up to 10 LPM with exertion? - Thanks for the help