SOMNONIV group

Nice first webinar for difficult traces with the SOMNONIV group, congratulations to the experts who found all the causes! not so obvious...do no be depressed...it was expert level...splf.fr/somnovni/

Always the same question with Cheyne Stokes ventilation…are upperairway opened or closed during the « central » event. Here a CS in post stroke. Your opinion?

Le questionnaire sur le monitoring est toujours en cours, nous avons 75 réponses, merci de rajouter les vôtres pour monter à 100!! forms.gle/jnc56HgfXSMEz4…

What are these big abdominal movements? spontaneous ventilation and the traces are (spo2/nasal flow/thermistance/ thorax and abdominal belts) ….our hypothesis leg movements…what do you think?

A survey about monitoring! we would be interested to know if we are useful 😅 and to prepare the future for you ! forms.gle/HXG7wz8qzB8rqz…

New quizz, new traces with more details in the answers...the new 2023 traces are here socrative.com Classroom : SOMNONIV2023

Beautiful semiology : no flow and opposition phase …obstructive apnea? Noooo ….the sound gives the answer! Be aware with « respiratory » patients

Copd patient with Paco2 at 50mm d’hg during the day….would you ventilate this patient? A polysomnography would ve very usefull but as the delay is 3 months….we are going to ventilate him…that’s real life…and that’s probably why copd is the first pathology ventilated at home

Snoring? Heart beat? Encumbrance? Not so obvious….

Severe COPD patient, Paco2 48mmhg under niv…the zero line is badly calculated by the software or massive autoEpap? The inefective efforts confirm that it is autoPep…what to do? That’s another question😨

Autotriggering yes! but due to obstructions… (decrease of the flow). Here we just change the trigger that was very sensitive…few obstructions that we respect

A good indirect sign for leaks : when the triggered cycles decrease and the control cycles (wrongly due to leaks (red circles) increase…decrease the triggered cycles is not always a good point!

Copd are difficult patients to ventilate!!! Even if the Paco2 is normal (from 68 to 48 today!!) but even with very high IPAP sometimes the lung is at this maximum…even if the ventilator AND the patient would like more

And many discussions to conclude…autotriggerings …not uncoupling neither reverse triggering because the first big cycles are not controlled!!!

The level is higher and higher….😱

A new somnoNiv workshop today in Paris. The best moment : lecture of traces. Easy to start double triggering

French tour of @GAVSPLF .In Metz with Dr Mercy, the local pneumologist and member or @gavsplf reading difficult traces

Typical autotriggering : the same cycles, with quite no inspiratory volume and no expiratory volume …the problem of the very sensitive triggers! (1)