Reverse 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.
Read MoreAirway occlusion pressure (P0.1)
Irene Telias MDCritical Care FellowSt. Michael’s Hospital and University Health NetworkInterdepartmental Division of Critical Care MedicineUniversity of Toronto Case vignette 56 yo gentleman recovering from severe ARDS, muscle paralysis was discontinued 24hrs ago. Still on continuous sedation with Propofol and Midazolam. Clear “asynchrony” on the ventilator with frequent double cycling. Oxygenation has worsened in the…
Read MoreDiaphragmatic Myotrauma: Definition and Importance
In this post, Ewan C. Goligher, MD, PhD answers questions related to Myotrauma and provides insights into the recent analysis published in Lancet Respiratory Medicine.
Read MoreExpiratory Flow Limitation (EFL)
Expiratory flow limitation (EFL) is often associated with the presence of auto-PEEP. There are simple bedside maneuvers that can be done to determine the severity of EFL. For this subject, the CoEMV invited Detajin Junhasavasdikul MD, first author of a paper on the subject published in Chest, 2018.
Read MoreInterpret This Waveform Pattern
The results are in! There were multiple correct responses. The patient indeed has high resistance as shown by the large difference between peak-inspiratory pressure (PIP) and plateau pressure (Pplat). They also have significant expiratory flow limitation as suggested by the shape of the expiratory flow-time curve (methods for assessing EFL will be included in another…
Read MoreFlow Starvation
Flow starvation is a form of patient-ventilator dyssynchrony that occurs when a patient is demanding more flow than the ventilator provides.
Read MoreName this Asynchrony 3
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Read MoreVentilation Workshop Day – Canadian Critical Care Forum 2018
There are still spots available for the Ventilation Simulation workshops during this years Canadian Critical Care Forum in Toronto Ontario Friday, November 9th. Visit the site for more information.
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