Thanks for the nice compliment! Unfortunately, some people struggle with insecurities that they mask through negative reviews and comments. It sadly makes them feel better. If you don't have haters, you're not making an impact! Go Be Great!
I really appreciate all of your videos, I am on my second year in school and since covid happened it has been difficult to get tutored and ask more questions to out professors. You have helped me tremendously. I love the passion that you have it gives me hope that things are not as complicated as it seem to be. Thank you very much for your help. I appreciate it.
Things are never as complicated as they seem. We complicate them. Think critically, but simple, and everything gets simple! Thanks for watching and commenting. Enjoy your ride to RRT!!!
Makes total sense! For the sake of simplicity, though, can we say that the value of Dynamic Compliance is the Tidal Volume divided by the Pressure Support?
Hi Respiratory Coach! Could you please make a video regarding control of ventilation? (central chemoreceptors, peripheral chemoreceptors, hearing Breuer reflex, etc...) thank you!
Dynamic compliance is always lower than static compliance. I'm confused as to the normal values that you present. Is the normals for static suppose to be 60-90 and dynamic compliance is suppose to be 30-60?
Yes sir. I misspoke on those values and am in the process of refilming this video. You are correct! Dynamic is always less than static, because pip is always higher than plateau. Thank you for this contribution.
Thx for help, cz in russia it’s all being described so academically complicated, w/o providing residents’ general understanding. Recommended to my colleagues from ICU.
Can you also elucidate why 0.1-0.4L/cmH20 which is 100-400mml/cmH2O is Normal Compliance (200ml/cmH2O) and I am referring to 60-90ml/cmH2O as the acceptable value regarding static compliance?.. That confuses me.. You said in the video "If you have a tidal volume of 400 and you divide by 0.1, you get the acceptable value of 40". Still not getting it.. You're awesome. Thanks so much for the help. Hopefully you can further clarify that point.
Hey, Patrick. Send me an email, please. respiratorycoach@gmail.com. I'm interested in discussing this further with you. You raise some interesting points that maybe we can discuss via phone? My hope is to help it make sense, but I've clearly failed on this one for you. I'll keep an eye out for your email. Thanks, Patrick!
OK, question, I am an RN in the ED and have been studying the ventilator for a little bit now. Let's say I have a pt that I'm concerned about for developing ARDS. How do I set the ventilator, together with my friendly neighborhood RT of course, to hold a breath long enough to monitor the plat on a constant basis? That information could be useful, even critical, for monitoring the progression of my pt. Although, the increasing plat would also increase the PIP, would it be adequate to just set an alarm for the PIP? Is it possible for the Pplat to increase without the PIP going up as well? Dynamic compliance by definition is a combination of both right? I think we use the Puritan Bennett 980. I guess you answered the question somewhat in the video lol, but I figure I'd leave this up.
Great questions Doug. You can set an alarm for PIP, but keep in mind when that high pressure limit is reached it terminates the breath, which will decrease tidal volume, minute volume, and will affect your acid-base balance. Pplat, when assessed correctly with a resting diaphragm and no patient effort, is always less than Ppeak. And yes, that's becuase Ppeak includes the airway resistance component while flow is present. Hope this helps!
@@RespiratoryCoach yeah, makes total sense. The inverse relationship between dynamic and static compliance and the corresponding PIP and Pplat is very useful information I didn’t understand before. I assume all these values would only be valid under the same flow rate right? If you change the flow rate you change everything. And lastly, the difference between your PIP and Pplat is considered the driving pressure, right? Therefore, changing you I:E ratio (specifically your I time) would change your flow rate, right?
Hi Joe. I would like to ask you about plato pressure measurement. My ventilator (Hamilton) and anesthesia maschine (Draeger Perseus) actually measure Plato pressure during the AC pressure mode of ventilation. Is that posible? I can send you a picture of that. Thank you for your great videos, they are tremendously educative.
Hey, Tina! First it depends on the compliance of the lungs based on the present disease process. Beyond that, in regards to paralytics, by eliminating any patient-ventilator asynchrony you'll see improved compliance. However, with prolonged administration of paralytics (a pet peeve of mine) you'll see complications that will reduce compliance. For example, impaired mucus clearance might lead to mucus plugging and atelectasis. This will obviously reduce compliance. Likewise, many paralytics initiate histamine release, which might cause bronchoconstriction, which will increase Raw and decrease dynamic compliance. Lots of variables to this great question! Thanks for posting it!!
Hello my friend. I'm an RT student .I'm watching your videos and learning a lot from you. I have a question . I f you are on AC/PC and you see a reduction in VT due to airways secretions , or let's say that the ETT is too small ,or if you have a COPD pt.. What happens with P plateau and static compliance ? I'm a little confused with that . I hope you can help me with that . thank you so much for taking your time and helping all of us .
Thanks to these videos, I’ve been encouraged to make this part of my Critical thinking presentation for my department’s annual skills fair. I’m limited to 20min. But I’ll make the most of it. BTW, passed my ACCS 😁 woot woot!! #continuingEducation😉
Respiratory Coach It wasn’t a big presentation. Just 8 small sessions in trouble shooting a trauma scenario, SBAR communication, and I focused on this topic obviously. I did record it for you (sound only). If you send me your email I’ll send it to you. Would love your feedback. I can take constructive criticism😉. I will tell you, my time frame was only 25min. So limited on how to present (KISS strategy).
@@mariaholivella5058 Sounds like a great strategy. Would love to listen to it. Send to respiratorycoach@gmail.com. Thank you for being a leader and an advocate for our profession. Strong work!!
Thanks very much sir , but a have a question of what makes the pressure drops for PIP to plateau since there no expiration occur , i mean the same volume is within the lung how come there is 2 pressures beside the PEEP ? Is it because of the flow ? Thanks in advance
@@RespiratoryCoach thank you very much for replying to me , also you have mentioned that The Plateau can't be greater than the PIP which it's make sense but is there a Possibility that they become equal
