@emireles_c @CCF_PCCM @ClevelandClinic @medpedshosp @msiuba @OfVentilation @_MSAMEED @RaedDweikMD @chatterJ5 @Thind888 @respitroy

@IM_Crit_ Whatever you do, please: "Do NOT turn the humidifier of the Vent off".

@curso_vm @Thind888 @Vent_Busters @JBradyScott @DrMiguelIbarra1 I don't know the type of circuits used in Brazil, but in the U.S the disposable circuit are pretty much the same manufacturer and the circuit compliance has little variation.

@Thind888 @curso_vm @Vent_Busters @JBradyScott @DrMiguelIbarra1 Ideally yes, but many things are not and that is why studies comparing modes like ASV vs similar ones were aborted. Many things in the vent are not as we think they are.

@curso_vm @Thind888 @Vent_Busters @JBradyScott @DrMiguelIbarra1 That is observed in many vents. Measurements done by vents are affected by many things and there are also certain range of error permissible. Accuracy comes at a higher price and that will drive costs higher.

@khaycock2 @IM_Crit_ @ThinkingCC @msiuba @nickmmark @cjosephy @Thind888 @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @Vent_Busters @ATC_Ventilator @SaudiRTs @ETR_MSPAS @KinesioCritica @MegriMohammed Agree. Was just pointing another way that favors fluid migration.

@IM_Crit_ @khaycock2 @ThinkingCC @msiuba @nickmmark @cjosephy @Thind888 @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @Vent_Busters @ATC_Ventilator @SaudiRTs @ETR_MSPAS @KinesioCritica @MegriMohammed In any VC mode, the flow waveform is preset. When the insp flow demand increases, the vent will not provide more flow, so Ppl decreases. You can liberate the flow (PC mode) but that is the end of strict Vt. An adaptive PC mode lessens the problem, but still WOB can be shifted.

@critconcepts @EM_phile @icuscenarios @mdonnino @almoskow When you measure Ptotal and the AOP is higher, the difference is the hidden PEEP.

@EM_phile @icuscenarios @mdonnino @almoskow The slow flow maneuver might help you to measure the hidden PEEP. When perform an end exp maneuver, you only measure the "average P of the open airways" not the ones closed. Anyways AOP causes trapped air and it is form of autoPEEP. What happens when the AOP>PEEPtotal?

@critconcepts @emireles_c @msiuba @OfVentilation @DrMiguelIbarra1 @ATC_Ventilator The incindense is high in ARDS, Obese, and in the combination of both. You can also use the P conductive during a regular passive breath to suspect the presence of AOP and perform a slow flow maneuver. The most important id that when AOP is present and ignored, it trick us.

@critconcepts @emireles_c @msiuba @OfVentilation @DrMiguelIbarra1 @ATC_Ventilator Well, remember that the airway is closed. You just open it. If ypu use the PEEP=AOP and you repest the maneuver, the P rises rectilineraly from the beginning. In CHF its value changes after CHF is treated. Before, the AOP was called the "lower inflection point" of the lung.

@critconcepts @emireles_c @msiuba @OfVentilation @DrMiguelIbarra1 @ATC_Ventilator I am trying to do it when I have a chance. The best chance is right after intubation when NMB are still working.

Lets see who are the brave ones: @DocMusician @ventilacionmeca @DrMiguelIbarra1 @emireles_c @CCF_PCCM @MegriMohammed @_MSAMEED @IM_Crit_ @critconcepts @OfVentilation @SaudiRTs @RespiratorySCCM @Vent_Busters @ATC_Ventilator @curso_vm @DrSateeshPCCM

@ATC_Ventilator Pt is very sedated.

@indignadoxd Y pensar que éste es el espermatozoide que ganó la carrera.....Que polvo al pedo. Infradotado.

@ElViejoFacho Pedenjos pelotudos. Se les nota la falta de clase/clases. sufren del síndrome de Baradel.

@GigliottiJavier Hijos de mil puta. Metanse ina zanahoria en el orto !!!