A case of COVID-19 and high respiratory drive
Provided by Dr. Nuttapol Rittayamai Case Synopsis A 59 years old man presented with COVID-19 pneumonia and severe ARDS. He was ventilated, heavily sedated and paralyzed, and received prone positioning for two consecutive weeks. After discontinuing cisatracurium, he developed asynchrony with the mode Pressure Regulated Volume Control (PRVC). We decided to put an EAdi catheter…
Read MoreMechanical Ventilation Symposium
There is still time to register! TARGET AUDIENCE All members of the ICU interprofessional team involved in the care of mechanically ventilated patients. Interested professionals will include physicians, respiratory therapists, nurses, physiotherapists. Experienced professionals and professionals-in-training will find this course relevant and very helpful in their clinical practice. GOALS Enhance ICU clinicians’ understandingof the physiological principles informing assessment…
Read MoreLung and Diaphragm Protective Ventilation
Lung protective ventilation is not a new concept in the world of mechanical ventilation. Extensive research has been published, and is continuing to be performed, to determine and confirm various mechanisms of lung injury. Diaphragm protective ventilation is relatively new concept in mechanical ventilation, with ongoing research looking at various mechanisms affecting this most important…
Read MoreRelations between dead space, respiratory rate, tidal volume and alveolar ventilation. Impact of protective ventilation settings and impact of instrumental dead space. Part 2
Based on the recently published paper “Impact of Respiratory Rate and Dead Space in the Current Era of Lung Protective Mechanical Ventilation”, we will discuss here briefly the different part of the dead space and how it can be reduced, as well as the relations with respiratory rate, tidal volume and alveolar ventilation (part 2).…
Read MoreHow to set the initial respiratory rate in critically ill patients and in the operating room? Impact for initial settings in mechanically ventilated COVID-19 patients. Part 1
Protective mechanical ventilation should be implemented after intubation in ARDS and in non ARDS patients, and in COVID-19 patients with pneumonia. However, protective ventilation does not just mean tidal volume reduction and we would like to focus here on the respiratory rate and the instrumental dead space. Based on the recently published paper “Impact of…
Read MoreA Message to Respiratory Therapists and Bedside Clinicians Regarding COVID-19 Management
Can we measure Plateau pressure during pressure support? And what does it indicate?
Pressure Support Ventilation is one of the most commonly used modes of assisted ventilation during the weaning phase. In patients who are recovering from the acute phase of both obstructive and restrictive lung diseases, monitoring respiratory effort and the total pressure distending the respiratory system is of invaluable help in order to maintain a “protective”…
Read MoreReverse Triggering
Reverse triggering is a type of dyssynchrony that occurs when a patient effort occurs after (‘is triggered by’) the initiation of a ventilator (non-patient triggered) breath. Usually, it is a phenomenon occurring over many consecutive breaths and also referred to as ‘entrainment’. Diagnosis The visual detecting of reverse triggering is slightly different between modes of…
Read MoreName this Asynchrony 4
What is the most likely form of asynchrony causing this waveform? Voting has ended, view the full write up on Reverse Triggering.
Read MoreMechanical Ventilation Rounds
Bedside Mechanical Ventilation Rounds are an excellent way to strengthen clinical knowledge of the subject. In this post we describe the rounds and provide tips for implementation in your institution.
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