Dude, 2 weeks ago the respiratory physician and intensivist gave a 40 min talk on NIV. Without a doubt, this was soooo much better with all respect to him. You need to realise you have a special talent in explaining these really obscure and non intuitive concepts so nicely and what you say is so relatable. Im starting to think medicine was meant to be taught by young doctors like you rather than the old heads who seem to not be able to connect as well and really answer the real questions us training doctors have.
Thank you so so much for such a kind comment! I really appreciate it so much and your words definitely are very inspiring and motivating for me to do more. Really hope I can keep creating videos that are helpful for people out there! Thanks again!! :)
@@ConanLiuMDthis was not about sleep apnea which a CPAP or BIPAP can be used for. I was put on what I think was a CPAP for sleep apnea and it was set from 4-15 and that was to increase as I went to sleep as needed. However I could rarely get to sleep because it felt like what I can imagine a ventilator feels like and it was hard to feel like you could breathe naturally. I managed to fall asleep for about 2 hours a couple times but never seen the ramp up go over 8. But when I woke up it felt like 20. I finally had to return it. Was the most unnatural breathing I ever experienced. Any ideas?
Wonderful video as always. My main concern with BiPAP on an altered patient is that it's very important that a patient be receptive to your coaching them to take slow, deep breaths. This is particularly important in contexts like rural hospitals or transport where the ventilators available may not be the newest and best. My agency, for example, uses the LTV1200 ventilator, the BiPAP capability of which is pretty... arguable. It cannot respond very well to someone who is taking irregular, rapid, shallow breaths, and such a person is going to have a very bad time unless we can coach them to take slow, deep breaths. Again, this is primarily a concern where the ventilators are older and less capable. As a side note, I've often wondered if ketamine has any utility with the patient on BiPAP who is refractory to coaching.
good video!! but I still have a question, so when you say increasing the IPAP will help the pressure support and cause them to expire more C02; why does that occur ? is that just from natural processes like the more we inhale the more we expire ?
Hard to tell and you should get evaluated further by your doctor. Could be CPAP doesn't have a good fit or needs some troubleshooting. Symptoms of waking up suddenly at night gasping for air could also be a sign of heart failure (we call it paroxsymal nocturnal dyspnea, though this is a bit different from the cough you are describing and you say it only happens very rarely so I doubt this is the case). You could also just be aspirating and choking on some saliva while sleeping too
hi dr. liu, i am epileptic and have multiple seizures every time i sleep. will either CPAP or BiPAP help with the seizures because i find that i snore and don't take in as much oxygen as i should. there is a flap in the back of my throat that prevents air from going in and out. i now have to sleep sitting up as if i am reading a book. please help. i am also concerned that if i do get either a cpap or a bipap that when i do have a seizure and my limbs swings around that it was break the machine by tossing it across the room. again, please advise.
I would definitely seek medical advice from your personal doctor and a neurologist! CPAP can definitely help with snoring/sleep apnea which could be a trigger for seizures, but you should definitely see your own doctor since they will know your history better.
Why CPAP is not able to increase TIDAL VOLIUME directly? It seems that CPAP can extend the lungs and increases FRC. Maybe the reason is that during expirium the patients have to overcome the High pressure of CPAP? Is this the reason why it doesn't able to ventilate (affect TV)? The air remains stuck in the lungs. In BPAP the patient deals with lower pressure during expirium. Is there something else that pressure support above peep does?
As a CPap user for sleep apnea this is the best explanation I've ever come across...thank you
Dude, 2 weeks ago the respiratory physician and intensivist gave a 40 min talk on NIV. Without a doubt, this was soooo much better with all respect to him.
You need to realise you have a special talent in explaining these really obscure and non intuitive concepts so nicely and what you say is so relatable.
Im starting to think medicine was meant to be taught by young doctors like you rather than the old heads who seem to not be able to connect as well and really answer the real questions us training doctors have.
Thank you so so much for such a kind comment! I really appreciate it so much and your words definitely are very inspiring and motivating for me to do more. Really hope I can keep creating videos that are helpful for people out there! Thanks again!! :)
Long time RT here. You sir are a gift to Everyone who watches. 😊
You explain things in a way that is easy to understand. Thanks!
You have a talent for being clear and concise. Please continue.
Thanks, am a nurse and totally enjoy your videos. Clear, direct, practical presentations that many can benefit from.
RT student hereI am so happy I came across your videos they are Super helpful, thank you so much!
Thank you so much. Concise and straight to the point
Thank you so much Conan; this has helped explain CPAP vs BIPAP quickly, succinctly and has definitely aided me as an ED nurse.
Excellent as always.
Brilliant and straight to the point. Thank you thank you and thank you 🙏
No, thank you!!! :)
thank you doctor.
Great video thank you!
Thanks for this video!
I was looking for a simple explanation of this
Thank you!! Hope it was helpful :)
@@ConanLiuMDthis was not about sleep apnea which a CPAP or BIPAP can be used for. I was put on what I think was a CPAP for sleep apnea and it was set from 4-15 and that was to increase as I went to sleep as needed. However I could rarely get to sleep because it felt like what I can imagine a ventilator feels like and it was hard to feel like you could breathe naturally. I managed to fall asleep for about 2 hours a couple times but never seen the ramp up go over 8. But when I woke up it felt like 20. I finally had to return it. Was the most unnatural breathing I ever experienced. Any ideas?
Great explanation!
this is to the point. thank you :)
Finally i get the point
Awesome explanation. Thank you!
Brilliantly presented
Thank you!!
Wonderful video as always.
My main concern with BiPAP on an altered patient is that it's very important that a patient be receptive to your coaching them to take slow, deep breaths. This is particularly important in contexts like rural hospitals or transport where the ventilators available may not be the newest and best. My agency, for example, uses the LTV1200 ventilator, the BiPAP capability of which is pretty... arguable. It cannot respond very well to someone who is taking irregular, rapid, shallow breaths, and such a person is going to have a very bad time unless we can coach them to take slow, deep breaths.
Again, this is primarily a concern where the ventilators are older and less capable.
As a side note, I've often wondered if ketamine has any utility with the patient on BiPAP who is refractory to coaching.
Excellent points and really appreciate the teaching! Thank you :)
This cleared a lot! Thnx for sharing your k pledge with us
Excellent
awsome, great job
Does bipap machine auto detect when we inhale or exhale? Or we must adjust to the machine's timing?
Gold!
Doctor can Bipap work for upper airway resistance??
Conan, do you still use anki as a tool to study? Can you make a video to update us?
Yes I do! My last video was the one titled "Anki for 576 Days" - wondering if you saw that one?
good video!! but I still have a question, so when you say increasing the IPAP will help the pressure support and cause them to expire more C02; why does that occur ? is that just from natural processes like the more we inhale the more we expire ?
I have a c-pap and sometimes wake up coughing ( rare, but scary) I believe from holding my breath, I don't know. What thinketh you?
Hard to tell and you should get evaluated further by your doctor. Could be CPAP doesn't have a good fit or needs some troubleshooting. Symptoms of waking up suddenly at night gasping for air could also be a sign of heart failure (we call it paroxsymal nocturnal dyspnea, though this is a bit different from the cough you are describing and you say it only happens very rarely so I doubt this is the case). You could also just be aspirating and choking on some saliva while sleeping too
hi dr. liu, i am epileptic and have multiple seizures every time i sleep. will either CPAP or BiPAP help with the seizures because i find that i snore and don't take in as much oxygen as i should. there is a flap in the back of my throat that prevents air from going in and out. i now have to sleep sitting up as if i am reading a book. please help. i am also concerned that if i do get either a cpap or a bipap that when i do have a seizure and my limbs swings around that it was break the machine by tossing it across the room. again, please advise.
I would definitely seek medical advice from your personal doctor and a neurologist! CPAP can definitely help with snoring/sleep apnea which could be a trigger for seizures, but you should definitely see your own doctor since they will know your history better.
Would you use BiPap with an ALS patient who doesn’t want invasive ventilation?
Why CPAP is not able to increase TIDAL VOLIUME directly? It seems that CPAP can extend the lungs and increases FRC. Maybe the reason is that during expirium the patients have to overcome the High pressure of CPAP? Is this the reason why it doesn't able to ventilate (affect TV)? The air remains stuck in the lungs. In BPAP the patient deals with lower pressure during expirium. Is there something else that pressure support above peep does?
Jazaak ALLAH U KHAIR ❤
goat
Why not just use bipap for all issues then
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