To apply for a state-funded technical assistive device - a bi-level positive airway pressure (BiPAP) mechanical lung ventilation device for conditions causing pulmonary hypoventilation
Required documents:
Pulmonologist or anesthesiologist-reanimatologist prepared opinion in the E-health system for receiving the technical assistive device. It must specify:
Examination results that justify the indication for BiPAP therapy, i.e., transcutaneous capnography or arterial blood gas results and/or spirometry or inspiratory muscle strength data.
Self-care and mobility ability assessment according to (the score is from 16 to 20).
About the BiPAP device:
The required operating mode and characteristics of the BiPAP device: inspiratory and expiratory positive airway pressure, support frequency, inspiratory duration
The usage time and duration of the BiPAP device
Type of non-invasive lung ventilation mask
The person must submit to the Vaivari Technical Aids Centre:
Application for the allocation of a technical assistive device.
Self-care and mobility ability assessment according to the Barthel index (index from 16 to 20 points).
Adults with chronic respiratory failure – chronic hypercapnia during the day and/or only at night (elevated paCO2 > 45 mmHg or elevated transcutaneous CO2 at night) or with progressive respiratory muscle weakness in the case of amyotrophic lateral sclerosis, the person is modified independent, able to use the respiratory mask themselves, with minimal or episodic assistance from others in daily activities (assessed according to the Barthel index from 16 to 20 points).
Indications for BiPAP therapy include one of the options:
To receive a state-funded technical assistive device – a bi-level positive airway pressure device (BiPAP) for mechanical lung ventilation in cases of pulmonary hypoventilation, the following documents are required.
1. Opinion from a pulmonologist or anesthesiologist-reanimatologist in the E-health system regarding the receipt of the technical assistive device. The opinion must include:
- examination results that justify BiPAP therapy. For example, transcutaneous capnography (measuring the amount of carbon dioxide in the blood through the skin) or arterial blood gas results. Spirometry (measuring lung volume and breathing rate) data or inspiratory muscle strength data may also be included;
- self-care and mobility ability assessment. This is conducted according to the Barthel index. The score is from 16 to 20. This means that the person mostly takes care of themselves and moves independently.
2. Information about the BiPAP device:
- required operating mode and characteristics. For example, inspiratory and expiratory positive airway pressure, support frequency (how often the device assists in inhalation), inspiratory duration;
- usage time and duration of the BiPAP device. For example, only at night or both day and night;
- type of non-invasive lung ventilation mask. For example, nasal mask or full-face mask.
The person must submit to the Vaivari Technical Aids Centre:
- application for the allocation of a technical assistive device;
- self-care and mobility ability assessment according to the Barthel index (from 16 to 20 points).
BiPAP devices are allocated to adults with chronic respiratory failure. This means that breathing is persistently too weak. For example:
- there is chronic hypercapnia (elevated carbon dioxide levels in the blood) during the day and/or only at night. This is determined if paCO2 is above 45 mmHg or elevated transcutaneous CO2 at night;
- there is progressive respiratory muscle weakness, for example, in the case of amyotrophic lateral sclerosis.
The person must be modified independent. This means:
- the person can use the respiratory mask themselves;
- the person performs daily activities independently. For example, they eat, wash, dress themselves;
- assistance from others is minimal or only occasional. This is assessed according to the Barthel index (from 16 to 20 points).
Indications for BiPAP therapy include one of the options (usually followed by a list of specific options).
During the day, arterial blood gas analysis shows a partial pressure of carbon dioxide (paCO2) ≥45 mmHg or;
Increased transcutaneous carbon dioxide level (ptCO2) ≥ 55 mmHg for at least 10 minutes during the night or;
ptCO2 increased by more than 10 mmHg during the night compared to the day, and is above 50 mmHg for at least 10 minutes or;
During the night, paCO2 ≥ 50 mmHg in two repeated analyses with a 10-minute interval, or;
the patient is acutely hospitalized with disease decompensation.
During the day paCO2 ≥ 45 mmHg or;
ptCO2 increases at night ≥ 50 mm Hg or increases > 10mmHg compared to wakefulness, for at least 10 minutes, or; If diagnosed amyotrophic lateral sclerosis (ALS) or another rapidly progressive neuromuscular disease, also if in spirometry forced vital capacity (FVC) < 60% of normal or maximum inspiratory pressure (MIP) < 40 cmH2O or;
During the day paCO2 ≥ 45 mmHg or;
At night > 50% of the time ptC02 > 50 mmHg; At night paCO2 ≥ 50 mmHg in two repeated analyses with a 3-hour interval.
During the day paCO2 ≥ 45 mmHg, or;
At night ptCO2 ≥ 50 mm Hg or increases > 10 mmHg compared to wakefulness, for at least 10 minutes, or;
At night paCO2 ≥ 45 mmHg in two repeated analyses with a 10-minute interval
At least 14 days have passed since 1 year, since the HOPS exacerbation with inpatient treatment and daytime paCO2 > 52 mmHg, or;
There have been 2 repeated hospitalizations due to HOPS exacerbation and acute hypercapnic respiratory failure in the last year, or;
No exacerbations or 1 hospitalization due to HOPS exacerbation in the last year and:
paCO2 ≥ 50 mmHg during the day, or;
paCO2 ≥ 55 mmHg at night, or;
paCO2 45-49 mmHg during the day and ptCO2 increase ≥ 10 mmHg for at least 10 minutes at night or paC02 increase of 10 mmHg in two arterial blood gas analyses with a 10-minute interval.
Night polygraphy or polysomnography performed, in which central sleep apnea was diagnosed, and;
during the day paCO2 ≥ 45 mmHg, or;
at night paCO2 ≥ 50 mmHg in 2 measurements with a 10-minute interval, or;
at night ptCO2 increases by more than 10 mmHg compared to the day for at least 10 minutes.
+371 67 552 350
vtpc@nrc.lv
