WeVent

Mechanical Ventilator Education on the go!

[Jones & Bartlett Learning @JBLearning]

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!

[Eduardo Mireles-Cabodevila @emireles_c]

The answer: Early cycling it is! How do you deal with it? #VentRounds @CCF_PCCM @CleClinicRespir #FOAMed #SoMe4MV

[Eduardo Mireles-Cabodevila @emireles_c]

What is the patient-ventilator discordance

[WeVent @we_vent]

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

[WeVent @we_vent]

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_c]

Here is the answer! Work shifting indeed. Great job @krveshi @msiuba @siddharth_dugar @SGBraunthal @Thind888 #VentRounds #MedTwitter A deeper explanation at https://t.co/YUtHrVCfIB

[WeVent @we_vent]

Can plateau pressure be higher than peak pressure? Read 👇

#WeVentWednesdays @some4mv

[Centre of Excellence in Mechanical Ventilation @SMHCoEMV]

Can we measure Plateau pressure during pressure support? And what does it indicate? https://t.co/B4cAuniXzW

[WeVent @we_vent]

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

[WeVent @we_vent]

1/ Lesson#9: Proportional Assist Ventilation (PAV)

#WeVentWednesdays #WaveformsMatter

@CritCareMed @some4mv
#FOAMed

References:
https://t.co/pbuM9XzsQH
https://t.co/KyroKMkhDj
https://t.co/hsB64aJ7VA

[WeVent @we_vent]

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

[Critical Care Medicine @CritCareMed]

Wolbrink et al : GamER Study-residents had superior knowledge acquisition with virtual ventilation simulator before PICU rotation.

Link:https://t.co/Jjrn3PNmKS

@sccm #CritCareMed #MedEd

Fig : Change in test scores throughout the study by arms

[WeVent @we_vent]

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:
https://t.co/iq3XUOEmWf
https://t.co/5haTrhIJqS
https://t.co/FPIlARXtOP

[WeVent @we_vent]

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:
https://t.co/XBuzPGTRiS
https://t.co/HyJMMkUcnI

[WeVent @we_vent]

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

[WeVent @we_vent]

Additional resources:
https://t.co/IpJ7Q3Ullc
https://t.co/D3uP856wLQ
https://t.co/OvXMEDLgl8
https://t.co/p9IXFGya2s

Check out this video!
https://t.co/L7mja5ES6M

[WeVent @we_vent]

1/ Lesson#7: Airway Pressure Release Ventilation (APRV)

#WeVentWednesdays #WaveformsMatter

@CritCareSociety @ATSCritCare @CritCareMed
#EMCritCare #PulmCC #AnesCritCare #FOAM

Lesson based on and modified from https://t.co/WrRwaWasl0

[WeVent @we_vent]

Advantages and Disadvantages in APRV

Weaning APRV with “Drop and Stretch” – reduce P high and increase T high until reaching CPAP