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 last 6 hours. You go to the bedside and find: What maneuver can help you understand the underlying…

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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.

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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…

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Flow starvation is a form of patient-ventilator dyssynchrony that occurs when a patient is demanding more flow than the ventilator provides.

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Short cycling is a common form of patient-ventilator dyssynchrony. It occurs when a patient-triggered breath cycles off prior to the patient effort being completed.

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Since its completion, the LUNG SAFE database has been utilized to answer a wide range of clinical questions regarding global practice. With the help of one of the authors, Dr. Tài Pham, we have provide a list, with brief synopsis of the currently published research, as well as upcoming future/planned analyses.

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