Tuesday, November 27, 2012

CPAP as a LOW TIDAL VOLUME VENTILATION STRATEGY



Image 1: Ventilator Screen Shot of Continuous Positive Airway Pressure. 


In October’s issue of the Chest Journal, a few colleagues of mine authored the abstract “The Use of Invasive Continuous Airway Pressure for Low Tidal Volume Ventilation”.

 This abstract was very intriguing to me for various reasons, one this goes against many traditional methods of providing ventilatory support for the patient with Acute Lung Injury and/ or ARDS.

Zealots of Airway Pressure Release Ventilation would argue that using pure CPAP would lead to extreme work of breathing and not off load the respiratory muscles sufficiently.

I myself would be concerned about using CPAP only, especially in extra-pulmonary ARDS primarily sepsis and septic shock where patients metabolic demand is high, which leads to a vigorous inspiratory demand. Off-loading these patients is very difficult and even using APRV or traditional methods leads to severe hypercapnea.  

However, I was baffled so I questioned my friend Troy Whitacre, a coauthor of the abstract to find more details and to share his experience.

Monday, November 19, 2012

Tuesday, November 13, 2012

New Project: Concepts of Mechanical Ventilation




I have started a new project called "Concepts of Mechanical Ventilation".

This will be a educational page reviewing basic to advance concepts of mechanical ventilation.

I will be adding short educational videos, which links can be accessed under the "Video Library" tab at the top of this Blogs  page.

The above video is an example, more to come.





Saturday, November 3, 2012

The Versatility of Mid-Frequency Ventilation



video


MFV first proposed in the medical literature in 2008 as a “conceptual” [1] ventilator modality which maximizes alveolar ventilation and minimizes the delivered tidal volume. MFV provides an alternative to traditional Volume-Control (VC) ventilation for patients with ARDS. This is extremely beneficial because lung protective strategies using VC ventilation are limited by predestined hypercapnia and hypercapnic acidosis.