يوميات RT 🫁

https://www.youtube.com/live/ERqy2Q6bUSU?si=k-giYfnVSIIp_Eel Great lecture that’s discussed the following: 1) The reasons that the current ARDSnet low tidal volume protective ventilation strategy has not further lowered ARDS-related mortality 2) Describe the dynamic pathophysiology in the microen…

Answer: Increase PEEP to 8. في البداية تصحيح لمعلومة مغلوطه نوعًا ما انه PEEP بس لتحسين Oxygenation وهذا غلط. في ذا الكيس SpO2 كان نورمل على FIO2 40%. بس CO2 high بسبب low Vt despite giving considerable high set PC for a normal lung. وبناءًا على CXR نلاحظ وجود Bilateral infiltration وهذا يعني ان…

A 26-year-old male, post-RTA, intubated with an ETT size 7.5. The last ABG shows pure respiratory acidosis (PaCO2 = 56). The current MV settings are: Mode: PC-AC Set PC: 20 (delivering 6ml/kg) Set RR: 20 PEEP: 5 FiO2: 40% V/S: HR: 94 SpO2: 99% BP: 132/73 His CXR, as shown above—what is the approp…

What is the cause of this ventilator waveform? And what is the possible diagnosis? —— #Mechanical_ventilation

How to differentiate between Reverse Trigger and double trigger, early cycle, or flow starvation? • Simply by doing a long expiratory hold and watching for any patient effort: • Presence of patient effort → Then it is not a Reverse Trigger. • Absence of patient effort → Then it is likely a Rever…

Answer: Reverse Trigger (RT) • It occurs when the ventilator triggers the body’s respiratory muscles to contract, rather than the body initiating the breath. باختصار، في الوضع الطبيعي، البيشنت يسوي كونتراكشن لدايفرام، والي بدورها تسوي تريقر للفنتليتر عشان يعطيه بريث. في حالة الـ Reverse Trigger، يصير العكس تمامًا؛ الفنتليتر هو اللي يسوي تريقر للبريث (time trigger)، وأثناء الشهيق هذا يصير تريقر للدايفرام ويصير له كونتراكشن، و هذا يسبب ظهور الاسينكروني على القراف بالاشكال التاليه: • Flow starvation • Early cycle • Double trigger ملاحظة🔴: تعديلك على I:E ratio او الvolume كله ماراح يوقف هذا الشي لانه الكونتراكشن الي حاصل involuntary اساسًا it is not a real patient effort!!

What is happening here? —— #Mechanical_ventilation

<<Reverse Trigger (RT)>> It is defined as an atypical interaction between the ventilator and the patient. It occurs when the ventilator triggers the body’s respiratory muscles to contract, rather than the body initiating the breath. This creates a repetitive pattern where the ventilator leads, and …

Reverse Trigger (RT) — #Mechanical_ventilation@RTDiary1

#Mechanical_ventilation

Another method with similar concept called Synchronized Abdominal Compression (SAC). This method used compression belt, connected to a second ventilator, applies synchronized abdominal pressure during the expiratory phase of breathing. The process requires careful synchronization, patient sedation, …

Manual / Mechanical External Chest Compression (MECC) in Severe Air-Trapping Asthmatic Patients ————— One of the most life-threatening complications of asthma attacks is air trapping and dynamic hyperinflation of the lungs, which can lead to pneumothorax and respiratory failure. 🔹A potential interv…

Subglottic Secretion Drainage-Endotracheal Tube (SSD-ETT) #Airway_management@RTDiary1 ———— The SSD-ETT features a small hole located above the cuff and at the rear of the tube. An internal channel runs along the tube and connects to a suction port, enabling either continuous or intermittent removal…

Answer: Hiccups • Hiccups result from the sudden, involuntary contraction of the diaphragm (- pressure), followed by the abrupt closure of the glottis. This closure produces the characteristic “hic” sound. • In neonates, chest depression during hiccups is primarily due to High Chest Wall Complian…