During noninvasive bilevel positive airway pressure (BiPAP) ventilation it is found that several times patients are unable to maintain oxygen saturation and develop breathing difficulty despite its high setting and high oxygen flow, further management requires invasive positive pressure mechanical ventilation. Increasing oxygen concentration inside the BiPAP mask using nasal cannula with addition of another flow meter not only increase oxygen saturation but also make the patient more comfortable and prevent intubation and its complications. This dual oxygen therapy is particularly useful in patients where non invasive ventilation is required and avoiding the need invasive mechanical ventilation. High-flow nasal cannula oxygen therapy has many advantages over traditional oxygen delivery systems. Here, we are going to report two cases of patients on BiPAP in which invasive positive pressure ventilation was prevented using dual oxygen therapy using nasal cannula with flow meter and BiPAP mask with addition another flow meter in a single sitting.
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