@we_vent

Mechanical Ventilator Education on the go!

Joined August 2019
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We recently released Essentials of Mechanical Ventilation, a free online resource for clinicians and students working with COVID-10 patients. Learn more about this resource today!

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The answer: Early cycling it is! How do you deal with it? #VentRounds @CCF_PCCM @CleClinicRespir #FOAMed #SoMe4MV
Eduardo Mireles-Cabodevila@emireles_c9 May 2020
You walk by the ICU, you glance at a ventilator. This is what you see going on. No alarms. Patient looks comfortable. #VentRounds @CCF_PCCM #some4mv #FOAMed @CleClinicRespir
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What is the patient-ventilator discordance
17%Early trigger
23%Late trigger
47%Early cycle
12%Late cycle
821 votes • Final results
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So important to recognize the nuances of managing #ventilators in all patients, including those with #COVID19. You cannot safely just “set it and forget it”. See below for a breakdown of patient-vent discordance illustrated by @emireles_c @CleClinicRespir #ModesWithLimitations
Eduardo Mireles-Cabodevila@emireles_c28 Apr 2020
Here is the answer! Work shifting indeed. Great job @krveshi @msiuba @siddharth_dugar @SGBraunthal @Thind888 #VentRounds #MedTwitter A deeper explanation at rc.rcjournal.com/content/65/…
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Refer to Lesson #5 on @we_vent for breakdown of the mode PRVC including the pros and cons! @CCF_PCCM @SMHCoEMV @MayoPCCM @SCCM #EMCritCare #pulmcc
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Can plateau pressure be higher than peak pressure? Read 👇 #WeVentWednesdays @some4mv
Centre of Excellence in Mechanical Ventilation@SMHCoEMV13 Jan 2020
Can we measure Plateau pressure during pressure support? And what does it indicate? coemv.ca/can-we-measure-plat…

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 res…

coemv.blog
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1/ Lesson#9: Proportional Assist Ventilation (PAV) #WeVentWednesdays #WaveformsMatter @CritCareMed @some4mv #FOAMed References: bit.ly/2FBwmMA bit.ly/36Cb7Gz bit.ly/2N7diu7
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4/ PRO/CONS: Does not require addition hardware (like NAVA) Not available on all vents Invasive and noninvasive ventilation Patients > 20kg Does not resolve intrinsic peep Improves synchrony
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5/Good for patients with significant asynchrony and/or chronic respiratory failure. Not used for short term ventilation, HD instability or heavily sedated. In COPD patient in PSV, increased pressure--> more intrinsic peep & increased difficulty triggering --> resultant decr RR
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Wolbrink et al : GamER Study-residents had superior knowledge acquisition with virtual ventilation simulator before PICU rotation. Link:ow.ly/ETvI50xA3Ne @sccm #CritCareMed #MedEd Fig : Change in test scores throughout the study by arms
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1/Happy New Year WeVenters! Looking forward to an educational & productive 2020! Lesson#8:Let’s start off with a lesson on Neurally Adjusted Ventilatory Assist (NAVA) References for this lesson: bit.ly/36pWXbe bit.ly/2rKKXST
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6/Goal of setting NAVA level: unload the increased effort of resp muscles Techniques: 1) stepwise uptitration to achieve inflection point on curve below – Brander et al OR 2) set @ 60% of highest EAdi during SBT w/ 7cmH20 in PSV & retest daily until extubation – Roze et al
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7/Waveform analysis with NAVA (upper panel) & PS (lower panel). Note dyssynchrony in lower panel with ineffective triggering & pressure and flow waveform not matched to neural EAdi waveform Further reading: bit.ly/2rOpkRG bit.ly/2QynDAc bit.ly/356EGOY
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1/ Lesson#7: Airway Pressure Release Ventilation (APRV) #WeVentWednesdays #WaveformsMatter @CritCareSociety @ATSCritCare @CritCareMed #EMCritCare #PulmCC #AnesCritCare #FOAM Lesson based on and modified from bit.ly/33NAnYP
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Advantages and Disadvantages in APRV Weaning APRV with “Drop and Stretch” – reduce P high and increase T high until reaching CPAP
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Additional resources: bit.ly/2NKzRoT bit.ly/34Vv9KI bit.ly/350OVVc bit.ly/32Ltx4W Check out this video! youtube.com/watch?v=-rgrBtIL…
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