VentBusters

➡️ Define the TAG, loads, trigger, cycle @ArielG_RRT @ATC_Ventilator @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @Thind888 @_MSAMEED @curso_vm @RyanHughes_RRT @SMHCoEMV @juanfez97 @DrSateeshPCCM @JmNunezSilveira @PulmCrit @IM_Crit_ @JVentilation @CCF_PCCM @AGMRRT

Very nice discussion about "Automode - BIPAP" Letter to the editor-Author's response journalmechanicalventilation.com/less-usual-ven…

@msiuba Congratulations 👏🏿

@ArielG_RRT @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM I agree. A test will clarify the result of our conversation. check pressurization during 0/0 with any triggerable mode. In addition some ventilators have active exhalation valve. What do you think how it works?

@Vent_Busters @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM Flow sensitive P triggering? I know nothing about it. IMHOP what matters is what is being measured and used to trigger. We use an ASL5000 by IngMar and we can differentiate P from Flow as the triggering variable and that is a high fidelity simulator.

What is your interpretation? @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @Vent_Busters @IM_Crit_ @critconcepts @OfVentilation @MegriMohammed @DrSateeshPCCM @SaudiRTs @RespiratorySCCM

@ArielG_RRT @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM Most of them have flow sensitive pressure triggering. If you look at the datasheets or user manual of the ventilator, this value is assigned without distinguishing pressure/flow. It is best to test it with a model with precision…

@Vent_Busters @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM What about P triggering?

@ArielG_RRT @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM Is there a ventilator without bias flow today? It may be wrong to say all of them, you are right, but I think this is the case since the second generation of ventilators. If there is flow, there is also pressure. Physics...

@Vent_Busters @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM I would not say "all" based only on the findings of just this study. Most likely other do, but it has to be proved.

@DrSateeshPCCM @ArielG_RRT @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM All of the Ventilators provide pressure when you set zero… nature of working principle.. doi.org/10.4187/respca…

@ArielG_RRT @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @Vent_Busters @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM Does this ventilator provide any inspiratory pressure even when the inspiratory pressure is set to zero?

@ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @RespiratorySCCM @IM_Crit_ @critconcepts @DrSateeshPCCM @OfVentilation @Vent_Busters @SaudiRTs @MegriMohammed @MCastroSayat @MayoVentilation @respcare

@DrMiguelIbarra1 @ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @OfVentilation @ATC_Ventilator @SaudiRTs @DrSateeshPCCM It looks like PC. I think this is dual. VC-CMVd. Could it be @DrMiguelIbarra1 ?

@ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @Vent_Busters @OfVentilation @ATC_Ventilator @SaudiRTs @DrSateeshPCCM VC-CMVs. Some breaths are being cycled due to peak pressure reaching the set pressure limit (50 cmH2O in this case). Quite high elastic and resistive loads in this patient.

What is the TAG of the mode? How does this mode work? The vent is a Mindray and the mode is V-A/C. @ventilacionmeca @DocMusician @emireles_c @CCF_PCCM @DrMiguelIbarra1 @critconcepts @IM_Crit_ @Vent_Busters @OfVentilation @ATC_Ventilator @SaudiRTs @DrSateeshPCCM

@ArielG_RRT @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @IM_Crit_ @critconcepts @OfVentilation @RespiratorySCCM @MegriMohammed @DrSateeshPCCM @SaudiRTs Share ECG traces if possible?

What is your interpretation? What would you do next? @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @IM_Crit_ @critconcepts @OfVentilation @Vent_Busters @RespiratorySCCM @MegriMohammed @DrSateeshPCCM @SaudiRTs

@ArielG_RRT @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @IM_Crit_ @critconcepts @OfVentilation @RespiratorySCCM @DrSateeshPCCM @SaudiRTs @ventilacionmeca @MegriMohammed A difference in phase angles? That was the only thing that caught my attention...

What would you to improve this pt-vent interaction? Is is a bad one? @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @IM_Crit_ @critconcepts @OfVentilation @RespiratorySCCM @Vent_Busters @DrSateeshPCCM @SaudiRTs @ventilacionmeca @MegriMohammed

ICU Snaphots: Young patient, postoperative day #3, recovering from cardiothoracic surgery, still on the ventilator What mode is this one? What is the TAG? What - if any - asynchrony do you see?

‼️only 34% of the tested HME/HMEF passed the psychrometric test dx.doi.org/10.1089/respca…

@DrMiguelIbarra1 @ArielG_RRT @DocMusician @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @MegriMohammed @OfVentilation @ATC_Ventilator @SaudiRTs @RespiratorySCCM I’ve never seen before. Interesting!

@ArielG_RRT @DocMusician @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @MegriMohammed @OfVentilation @Vent_Busters @ATC_Ventilator @SaudiRTs @RespiratorySCCM Beats me. But I'm quite sure of: there are 2 PC breaths (one mandatory and one spontaneous) between two mandatory VC breaths, why?. I don't see a switch of control variable during the same inspiration, so I disagree with a dual scheme. This must be an automode, maybe PC-IMV(2)a,a

This is a tough challenge for the brave ones who like ventilatory modes: What mode is it? @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @MegriMohammed @OfVentilation @Vent_Busters @ATC_Ventilator @CCF_PCCM @SaudiRTs @RespiratorySCCM

@ArielG_RRT @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @critconcepts @IM_Crit_ @MegriMohammed @OfVentilation @ATC_Ventilator @SaudiRTs @RespiratorySCCM In my opinion could be VC-IMV(4)d.d or VC-IMV(1,4)d,ds due to this is dual mode-switch PC and early triggered breath PC.. @MegriMohammed what you think about VC-IMV(1,4)d.ds could be?

@emireles_c @msiuba @JieLiRRT @OfVentilation Done 👊

ICU clinicians - help a student out! Harley Qin, a 2nd-year RT student, studying esophageal pressure monitoring (IRB approved) If you have ≥1 year of adult ICU experience & manage mech vent, take this 5–10 min survey 🔗 redcap.link/cxaqi1dq @msiuba @JieLiRRT @OfVentilation

We developed a browser-based tool to predict ventilation impairments such as iPEEP buildup, hypoventilation, and desynchronization due to the tube resistance (also during bronchoscopy). Check it out: fabrylab.github.io/Bronchoscopy/

@ArielG_RRT @DocMusician @DrMiguelIbarra1 @emireles_c @OfVentilation @critconcepts @IM_Crit_ @RespiratorySCCM @SaudiRTs @ATC_Ventilator VC-IMV(3)s.s. resistive. There is no Pmus.

What mode is it? TAG? The vent is a Drager. @DocMusician @DrMiguelIbarra1 @emireles_c @Vent_Busters @OfVentilation @critconcepts @IM_Crit_ @RespiratorySCCM @SaudiRTs @ATC_Ventilator

IMHO, trials of n=1'000,000 comparing VC vs PC could be made, but differences in relevant outcomes should NEVER be found. This would only mean that the proficiency at using the "bad/negative" mode is questionable. Any thoughts?sciencedirect.com/science/articl…