So I have a question about a patient I take care of. While he was in the hospital his trach was changed from a 4.0 bivona to a 4.5 bivona. Now while at home, his peep is still set to 8, but his actual is 4 with cuff inflated and practically 0 while deflated. Is this dangerous?
What does the Respiratory Therapist say? What vent does he use? LTV 1150? Trilogy?
Older LTV with the PEEP in the circuit?
It's Ltv 1150 I'm thinking a leak bc it goes up to 4 when inflated .. his co2 has decreased from 45 usually to about 35 now after different trach size was hanged.
To your original question- if his CO2 is normal and he's not in distress- It's probably fine. Lower PEEP = less barotrauma.
lower peep = more atelectasis
If the PEEP is set to 8 and actual PEEP is only 4, then the cuff is not properly inflated. How dangerous is this? That depends on the child. PEEP improves oxygenation and prevents atelectasis. If the child has issues with oxygenation or issues with atelectasis, then you could be creating problems.