Centre of Excellence in Mechanical Ventilation
@SMHCoEMV
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The Toronto CoEMV at St. Michael’s leads in personalized evidence-based acute mechanical ventilation through collaboration, education, research, and innovation.
Toronto, Ontario
Joined February 2018
RT @Anter_Rodrigues: Check out our review about reverse triggering out on the @ATSBlueEditor We discuss from pathophysiology to clinical…
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RT @laveenamunshi: Standing room only at @CCCForum Women Critical Care physicians in Academic and Community ICUs #CCCF2022 thank you to @Je…
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@RyanHughes_RRT @ArielG_RRT @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @msiuba @Thind888 @_MSAMEED @curso_vm The strength of the POCC paper is the accurate detection of Pmus >10 and dynamic transpulmonary pressure >15. I would not fixate so much on absolute values.
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@Thind888 @RyanHughes_RRT @DrMiguelIbarra1 @ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @msiuba @_MSAMEED @curso_vm Yea and many of the patients in that study were receiving ECMO (16/30). So it certainly requires further study in not only ECMO, but in non-ECMO patients.
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@Thind888 @RyanHughes_RRT @DrMiguelIbarra1 @ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @msiuba @_MSAMEED @curso_vm We also wrote a blog post with Goligher describing key points.
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@RyanHughes_RRT @Thind888 @DrMiguelIbarra1 @ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @msiuba @_MSAMEED @curso_vm They published their physiological study testing feasibility. A third of the patients could not meet targets, some required partial NMB. So further data is needed to determine if this can translate into beneficial clincial outcomes.
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@RyanHughes_RRT @DrMiguelIbarra1 @ArielG_RRT @ventilacionmeca @DocMusician @emireles_c @msiuba @Thind888 @_MSAMEED @curso_vm I replied to this mentioning the calculation for Pmus (I accidentally used the wrong fraction and deleted the tweet). Then I realized you used the 2/3 and 3/4 correctly in another tweet 👍. We have a calculator to simplify this for clinicians.
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@RyanHughes_RRT @ArielG_RRT @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @msiuba @Thind888 @_MSAMEED @curso_vm I think maybe PC of 24 is above PEEP of 12. So peak is 36. PMI 44-36 = PMI 8
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@Martin_Kneyber As an example. The dotted line is the pressure control level. If there is sufficient effort by the patient, even a prolonged iTime (resulting in plateau) can show elevated pressure. If the effort is not sufficient it could be the same or lower than the set pressure.
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@Martin_Kneyber Not all ventilators allow plateau during pressure support. But whether plateau appears higher in pressure control comes down to timing (iTime), not a limitation of the ventilator.
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