We are wondering what other facilities are doing for patients on BiPAP or CPAP regarding medication and nutrition support.

There are concerns that even with the gut working, removing the respiratory support for even a few minutes has significant impact on some COVID-19 patients. The results seen include significant tachypnea and decreased oxygen saturation levels even for short periods of time.

The pharmacy team has been reviewing & consolidating medications moving to longer acting products when appropriate to decrease the number of times per day oral medications are needed, and recommending some medications be administered IV or IM if appropriate.

The ASPEN guidance document (see attachment) still recommends enteral before parenteral nutrition. There are concerns about BiPAP/CPAP fit when a tube is present having similar repercussions as if the device is removed entirely for eating.

Thank you,
Karen