Home ventilators are generally noninvasive ventilators that provide continuous positive pressure ventilation.
Continuous positive airway pressure ventilation is the safest and most effective noninvasive ventilation method for the treatment of sleep apnea syndrome (OSA).
Noninvasive ventilators are divided into three types according to their functions: single-level positive pressure ventilator (CPAP), automatic positive pressure ventilator (Auto CPAP), and bi-level positive pressure ventilator (BiPAP).
Single-level positive pressure ventilator (CPAP): It is a widely used ventilator in the clinic, which is able to continuously output a constant pressure, applicable to most of the patients with sleep apnea syndrome, with reliable therapeutic effect, economical and practical. However, if the therapeutic pressure is high (more than 12 centimeters of water column), for the lung function is not good or some middle-aged and elderly patients, may feel difficult to breathe (suffocation), or even difficult to tolerate.
Automatic positive pressure ventilator (Auto CPAP): also known as intelligent ventilator, it can automatically detect the patient's apnea and the amount of airflow lowering, and then according to the resistance of the upper airway, the phase of sleep, the position of the body to automatically output changes in pressure, to achieve the best therapeutic effect with the smallest output pressure, and better comfort. At the same time, this machine comes with data storage function, automatic record analysis of the use of the situation, assessment of the efficacy of treatment, adjustment of data, the function is more comprehensive.
Bi-level ventilator (BiPAP): It is a dual-airway pressure ventilator with the most comprehensive functions, which can be set up with higher inspiratory pressure and lower expiratory pressure respectively, providing higher inspiratory pressure to keep the airway open when the patient inhales, and lower expiratory pressure when he exhales to ensure smooth expiration of the patient. The machine and breathing can be synchronized, the machine is suitable for all kinds of apnea syndrome patients and all patients need to use non-invasive ventilation treatment, is currently the most comprehensive function of non-invasive ventilator.
Buying a noninvasive ventilator must pay attention to the following points:
1. Based on the diagnosis, to determine the purchase of the machine. Polysomnography (PSG) and sleep screening tests are the main methods of diagnosing sleep apnea syndrome (OSA). After the diagnosis is clear, the doctor will do pressure titration (the pressure needed for treatment), and at the same time, make a comprehensive examination of the lung function and the upper respiratory tract (mainly the nasopharyngeal cavity). The doctor will prescribe a diagnosis and recommend the type of machine you should choose.
2. Try on the machine to determine the best fit. Due to the different design features of different manufacturers' ventilators (especially automatic and bi-level machines), you can only confirm the most suitable model for you by trying on various types of ventilators with different data (pressure range, inspiratory time, respiratory rate, inspiratory/expiratory ratio, etc.).
3. Choose a good mask and match it with a heated humidifier. The sealing and comfort of the mask is directly related to the therapeutic effect and long-term compliance. Determine the type of mask by testing the height of the bridge of the nose, the width of the face, and debug the wear to determine the best. At the same time matched with a heating humidifier that can automatically adjust the temperature, it can greatly reduce the increased nasal resistance, dryness and other uncomfortable symptoms brought about by high-speed airflow, and comfort is greatly increased.
4. Regular monitoring to assess the efficacy . After wearing the machine should be regularly blood oxygen monitoring, data analysis, the occurrence of respiratory events should be fully analyzed, and timely adjustment of pressure and other data.
The following conditions can be treated with CPAP ventilator:
● Sleep apnea syndrome: CPAP ventilator is effective for patients with obstructive, central and mixed sleep apnea syndrome, and can be applied in the home for a long time. In addition, patients with severe sleep apnea syndrome before performing uvulopalatopharyngeal soft palatoplasty or patients with severe sleep apnea syndrome caused by hypothyroidism before thyroxine replacement therapy, short-term application of continuous positive airway pressure ventilation therapy can improve resistance syndrome patients can also apply continuous positive airway pressure ventilation therapy.
● Acute exacerbation of chronic bronchitis, emphysema, pulmonary heart disease patients with respiratory failure, or rehabilitation after stabilization.
● Respiratory failure due to critical asthma.
● Acute edema, early adult-type respiratory distress syndrome.
● Respiratory failure due to myasthenia gravis and other neuromuscular diseases.
● Respiratory insufficiency due to spinal deformities and other causes, ventilation support during or after anesthetic surgery.
● Application to transition from evacuation ventilator.
Generally speaking, CPAP ventilator is non-invasive, simple and easy to implement, and has no obvious side effects, but caution should be exercised when considering the use of CPAP ventilator in patients with sleep apnea syndrome in the presence of the following diseases.
● Chest CT or X-ray examination reveals the presence of pulmonary alveoli.
● Pneumothorax or mediastinal emphysema.
● Significantly reduced blood pressure, if shock is not corrected.
● Severe coronary artery disease.
● A case of intracranial pneumoperitoneum has been reported in a patient with sleep apnea syndrome treated with continuous positive airway pressure ventilation, thus the application of continuous positive airway pressure ventilation in the presence of cerebrospinal fluid leakage, craniocerebral trauma, or intracranial pneumoperitoneum needs to be carefully considered.
● Application of continuous positive airway pressure ventilation should be avoided during acute otitis media, and can be continued after the infection has resolved.