This post is from a suggested group
Patient with a chest tube
Hello everyone,
I would like to share this ventlator graphic with you
What is going on?
What is the best mode for this case?
Do you think SBT is possible?
77 Views
top of page
DISCUSSION GROUPS
We invite you to join our discussion groups and engage with other professionals on the latest critical care trials and advancements. Stay up to date on healthcare breakthroughs, trends, and reviews in the world of critical care; become a part of our collaborative community today!
Groups
View groups and posts below.
Public·1283 members
Public·514 members
Public·1399 members
Public·317 members
Public·148 members
Groups Feed
This post is from a suggested group
105 Views
This post is from a suggested group
Inspiratory hold maneuver
The above inspiratory hold screenshot may indicate all of the following except:
0%Pulmonary edema
0%Pneumothorax
0%Abdominal compartment syndrome
0%Bronchospasm
166 Views
Mazen Kherallah
05 Oca
So the plateau pressure is high indicating low compliance that you see in all listed conditions except bronchospasm
This post is from a suggested group
28 Views
This post is from a suggested group
Management of Sepsis-induced Cardiomyopathy
84 Views
This post is from a suggested group
Septic Shock
83 yo woman with morbid obesity, sleep apnea, DM, HTN, asthma, CAD who had presented at outlying facility for an elective cystoscopy with plans for laser lithotripsy and ureteral stent placement. During the procedure she became hypotensive and bradycardic. She was given atropine and epinephrine. Postprocedure she was initially extubated. Chest x-ray postprocedure showed right upper lobe and possible left lower lobe infiltrates concerning for aspiration. Troponins are positive consistent with non-STEMI demand ischemia. She has a severe metabolic acidosis with a lactate of almost 7. Her EKG showed sinus tach with a RBBB and no ischemic changes. She required to be intubated for severe respiratory distress. She was still hypotensive requiring norepinephrine and vasopressin despite 3 liters of LR. Her IVC was 1.4 cm. LiDCO was placed and the following hemodynamic parameters were obtained:
SVV was indicating fluid responsiveness and Pleth Variability Index was 18%:
SBP variation was also around 20%.
Patient was…
66 Views
Alexei Ortiz Milan
11 Oca
•
Great case, indicating that fluid resuscitation should be individualized according functional hemodynamic (SVV, PPV,PVI) and not all patients will require the same amount of recommended IV fluid of 30 ml/kg; some will require less and others will require more. In this patient we don’t know the weight, ideally the IBW once the patient is morbid obese.
The patient despite having get 3 L of RL continued having evidence of hypovolemia (small IVC size) and high SVV, PPV, PVI indicating that the patient is fluid responsive; will be good to know the IVC distensibility index which is another sonography parameter of fluid responsiveness in a ventilated patient.
Also, should be highlighted the role of vasopressors in this patient once the SVR is low and high CO, and widen PP (86 mmHg) which is a pattern of vasoplegia, probably due to septic shock.
Düzenlendi
This post is from a suggested group
Pericardia Effusion
Mild to moderate pericardial effusion with no obvious collapse of RV during diastole.
29 Views
This post is from a suggested group
The RSI Trial
Practical Applications in Clinical Practice
1. No Mortality Benefit
The trial found no statistically significant difference in 28-day in-hospital mortality between ketamine (28.1%) and etomidate (29.1%) groups (adjusted risk difference −0.8%, 95% CI −4.5 to 2.9; P = 0.65).
Implication: Either agent may be appropriate from a mortality standpoint, allowing clinicians to prioritize other patient-specific factors.
2. Risk Stratification
75 Views
This post is from a suggested group
Dr Maheen Munir
I completed Advanced Mechanical Ventilation Concepts!
113 Views
bottom of page
Thanks for sharing this ventilation graph. The is PRVC mode. It is noted that patient on mandatory RR 12/ min with 430 ml VTi and I: E ratio 1:2.0 but patient is tachycapnoec, RR 30/ min, it is reversed 1.9: 1 ratio, compromised expiration time, and dynamic compliance 15.9*
I believe that patient in volume trapping?
I will recommend to put him either ASV or AMV mode ( Adapted Support ventilation) according to ventilation options available. Either put him on spontaneous mode before proceeding SBT.
Either it is double triggering ?
Hopefully I will get a passing score.😀