I'm in a respiratory program and a fellow student recommended this channel, and I can definitely see why, you are great at explaining these concepts ! Thankyou sir !
I am sincerely thankful for all of your videos. I really like how you make the information and concepts easy to understand. Hands down best videos for future and current Respiratory Therapists.
Thank you! Awesome! Best wishes too! An experience I had regarding flow. I received a pt in ICU on a vent, he had a square wave flow, his HR was 133. So I read his lung Hs and he had no lung Hs. So I thought, hm!, in school I learned that a sine way is for normal lungs. I did hear his audible BS laterally. So, following what I learned, I placed him in a sine wave flow pattern. I went to chart near by, and in about 20 min his heart rate turned into NSR in the 70-80 range. Then the nurse said; and I remembered the beep sound of the alarm change, oh! He went into sinus mode! Then I went to the room and it was true. I say this cause I've been reviewing stuff in the net and I find teachers saying that square wave pattern is usually the norm on cycled ventilation. Just wanted to agree that! Thanks again and best wishes!
What is the difference between BIPAP and PSV mode? In terms of patients with tracheostomy, these two modes can apply to them. while there are differences in the specific terminology and pressure settings between the two modes, the underlying principles are similar. Both modes require patient-initiated breathing, involve the application of positive pressure to assist with inhalation, and provide a form of positive end-expiratory pressure (PEEP).
Very informative lectures and you are a very gifted teacher .I am a paediatrician and been following your channel recently ,any video training regarding neonatal ventilation ?
Hello. Not currently. I have little to no neo/pedi experience and therefore wouldn't attempt to present as an expert in that area. I've attempted to get my neo/pedi expert to join me for some videos, but haven't been able to make that happen. Hopefully soon!
So cpap + pressure support = bipap. Cause on cpap with pressure support you can increase TV as well. For example if you have bipap with an Ipap = 10 Epap=5 then PS =5 and it s the same as cpap = 5 and PS of cpap = 5 . So Ipap of bipap = PIP of cpap = 10. Is this false?
Do you have or can you do a video on peep compensated and peep non compensated ventilators, and explain what you have to do to adjust when switching ventilators ? Thank you
Your max pressures are when hemodynamics become negatively effected. Watch for a decrease in blood pressure. Plateau pressures are recommended to be kept less that 28-30 cwp. Max peak insp pressure is when you notice bird beaking on your p-v loop or in PC your tidal volumes become too large. The point is, there is no single number that is the max for every patient.
Hi Thank you for this illustration I have a question: if pressure support added above the PEEP why in pressure time scaler we reached 10 instead of 15 the sum of PS and PEEP
Hey Max. It'll be a minute but I'll get on it as soon as I can. Essentially, IVAPS operates on a target minute ventilation, similar to ASV. This is different than AVAPS, which operates on a target tidal volume, similar to PRVC. Make sense?
Thanks for explaining the concept of cpap and pressure support ventilation. can we call cpap as external PEEP. Can we apply CPAP to those who have obstructive airway disease as these patients have already increased FRC. Thanks Dr Anwar Ali from Pakistan
Hello Dr. Ali. I'm not sure I understand the "external peep" part. May you clarify? And yes, you can use CPAP with obstructive disease. It essentially becomes mechanical application of pursed lip breathing. The CPAP in this case is not so much used to increase FRC, but more so to stent open distal airways, which will allow for more completely exhalation and reduce the risk of airtrapping/autopeep.
@@RespiratoryCoach Is there a difference between CPAP of 5 with PS of 10 and BPAP of 15/5 !! In cardiology COP = SV ×HR Is it the same analogy in respiratory MV = TV x RR So as heart is failing it compensate by tachycardia Same wise if there is problem with minute ventilation it compensate by Tachypnea Which increases the WOB and finally Respiratory failure CPAP or EPAP reduces the elastic work to open alveoli while PS augment TV and improves minute ventilation and decreased CO2 retention I wanna hear from u if I have any erroneous concept of what I just said Thx
I'm a new user so this is all a different language to me, but my IPAP = 12.0 and my EPAP = 4.0 - Is this an OK pressure support. My diagnosis was 50 events/hr but these settings give me typically less than 3 events/hour.
In psv why flow is not change with increase of ps, but vt changes. Flow =vt/I time, is i time increasing with increase of tidel volume in psv. Pls clarify my doubt
All vents that I'm aware of consists of a CPAP mode. All vents may not refer to it as CPAP, such as the PB 840 and 980. Their CPAP mode is labeled spontaneous, but it is CPAP often times with PS.
Do we measure pip and mean airway pressure when patients on cpap vent mode? I’ve seen therapists measured. Patients is spontaneous breathing. Let me know.
Hi! I'm trying to understand the cycle mechanism being flow decay and not pressure in pressure support. Would the pressures delivered vary as well? If the cycle mechanism is flow decay and not pressure, is it possible that the pressures reached would vary? I hope that makes sense.
thank you @respiratory coach i have question , correct me if i am wrong i usually work on drager EVITA XL...and as a routine , i am always activating ATC " Automatic tube compensation" while on SIMV my question is should i add pressure support level LIKE 5-8 CmH2O to overcome artificial airway resistance or ATC alone is enough ? thanks alot
Ike, I looked back at the video to get a frame of reference to your question, but I didn't see anything related to an ABG or bipap. Can you give me a point of reference to refer to so I can answer your question?
I'm not sure, as I'm not familiar with the Trilogy. I would reach out to the rep with specific Trilogy questions. I know you can on the V60 and old school vision.
