NON-INVASIVE VENTILATION
|
|
- Godfrey Pitts
- 7 years ago
- Views:
Transcription
1 Barcelona Devices for severe heart failure NON-INVASIVE VENTILATION Josep Masip MD, PhD, FESC Intensive Care Medicine Department H. Moisès Broggi - Sant Joan Despí. Barcelona Consorci Sanitari Integral Associated Professor of Cardiology University of Barcelona SPAIN NO CONFLICT OF INTEREST
2 Barcelona Noninvasive ventilation (NIV) Noninvasive refers to the ventilation delivery (NIV) of refers mechanical to the delivery ventilation of positive to the lungs using techniques that do intrathoracic pressure without not require an endotracheal endotracheal airway. intubation. Hillberg RE, Johnson DC. N Engl J Med 1997 Mehta S, Hill NS. Am J Resp Crit Care Med 2001
3 Barcelona TWO COMPONENTS for NON INVASIVE VENTILATION SOURCE OF AIR - OXYGEN (VENTILATOR) INTERFACE (MASK)
4 Portable NIV ICU Ventilators Alarms Modalities Displays Leakage compensation Flow regulation
5 INTERFACES A B C D E F
6 TOTAL FACE MASKS Barcelona
7 Barcelona MODALITIES OF NONINVASIVE VENTILATION IN APE Continuous positive airway pressure (CPAP) Pressure support ventilation (NIPSV) Bilevel (BIPAP)
8 CONTINUOUS POSITIVE AIRWAY PRESSURE CPAP Pressure (cm H 2 O) normal CPAP Boussignac PEEP = 10 cm H 2 O 0 Time
9 PRESSURE SUPPORT VENTILATION NIPSV Pressure (cm H 2 O) normal PSV Tidal 370 ml Bilevel - BIPAP Tidal 540 ml Tidal 630 ml PEEP = 5 cm H2O Time
10 Barcelona THE EVIDENCE FOR NIV IN ACUTE PULMONARY EDEMA
11 CPAP Conventional CPAP
12 NIPSV ICU No AMI IPAP 20 EPAP 5 V T : 543 ml J. Masip. Lancet 2000
13 NEED FOR INTUBATION CPAP 1997 NIPSV RR = % CI P< RR = % CI P=0.002 RR = % CI P< Masip J et al. JAMA. 2005;294:
14 MORTALITY CPAP 1997 NIPSV RR = % CI P=0.003 RR = % CI P=0.07 RR = % CI P= Masip J et al. JAMA. 2005;294:
15 CPAP vs NIPSV Death RR = % CI P=0.82 Need to intubate RR = % CI P=0.39 Masip J et al. JAMA. 2005;294:
16 The 3CPO N=1069 distributed in 3 groups : 367 ST, 346 CPAP, 356 NIPPV ph < 7.35
17 Gray A, NEJM 2008
18 The 3CPO Gray A, NEJM 2008
19 The 3CPO Gray A, NEJM 2008
20 Masip J, Mebazaa A, Filippatos G. N Engl J Med 2008; 359: Different intubation threshold Different populations
21 The 3CPO 5/15 (33%) studies were performed in ICU Masip J et al. JAMA. 2005;294:
22 The 3CPO BASELINE ph 7.22 PaO2 100 mmhg Pa CO2 57 mmhg Gray A, NEJM 2008
23 Author ph PaO2 Bersten mmhg Lin mmhg Levitt mmhg Rasanen mmhg Kelly 89 mmhg Crane mmhg Park mmhg Masip mmhg Some delay in starting the protocol? Pre-hospital treatment?
24 European Journal of Emergency Medicine 2007, 14:
25 Acid lactic (mg/dl) Arterial ph Changes in pha, phv and Lactacidemia 30 pha phv Acid lactic Time after inclusion (min) Masip J. Unpublished data
26 Gray A, NEJM 2008
27 INTUBATION CPAP 56% Reduction Bilevel 44% Reduction Cui-Lian Weng. Ann Intern Med. 2010;152: ;
28 MORTALITY CPAP 36% Reduction Bilevel n.s. Cui-Lian Weng. Ann Intern Med. 2010;152: ;
29 CPAP Cui-Lian Weng. Ann Intern Med. 2010;152: ;
30 Barcelona NIV in APE in CLINICAL PRACTICE
31 Esteban A, et al Evaluation in the use of non-invasive ventilation in the ICU. Proceedings of the American Thoracic Society 2006;3: A Hypercapnic Asthma de novo CPE
32 EUROPEAN HEART FAILURE SURVEY Adherence to ESC guidelines for AHF in Europe. EHFS-II 410 Patients with Acute Pulmonary Edema Therapy Indication Class EHFS CPAP / NIPPV Acute Pulmonary Edema IIa B 22.4% & Hypoxemia Mechanical - No response to medical IIa C 11.5% Ventilation treatment & CPAP With Intubation - Post cardiac arrest 32
33 ADHERE Registry Tallman T. Academic Emergency Med 2008; 15: 1 8
34 Crit Care Med 2005;33:
35 Pre-hospital setting
36 Number of patients INTUBATION RATE * * p<0.05 Early CPAP Late CPAP * Pre-hospital Hospital OVERALL Plaisance et al. Eur Heart J 2007
37 Number of patients HOSPITAL MORTALITY * * p=0.05 Early CPAP Late CPAP Plaisance et al. Eur Heart J 2007
38 CONCLUSIONS in patients with ACPE The use of NIV has increased in the last 20 years and ACPE is currently the second indication for this technique. CPAP and NIPSV are safe techniques that improve the acute respiratory failure faster than conventional oxygen therapy. CPAP is simpler and does not require special equipment or experience. Both techniques reduce the intubation rate, whereas CPAP may reduce hospital mortality, particularly in high-risk ischemic patients. NIV, primarily CPAP, should be used early, on arrival or preferably, in the pre-hospital setting (ambulance).
Non-Invasive Positive Pressure Ventilation in Heart Failure Patients: For Who, Wy & When?
REUNIÃO CONJUNTA DOS GRUPOS DE ESTUDO DE CUIDADOS INTENSIVOS CARDÍACOS E DE FISIOPATOLOGIA DO ESFORÇO E REABILITAÇÃO CARDÍACA O L H Ã O 2 7 e 2 8 d e J a n e i r o 2 0 1 2 Non-Invasive Positive Pressure
More informationImportance of Protocols in the Decision to Use Noninvasive Ventilation
Importance of Protocols in the Decision to Use Noninvasive Ventilation Janice L. Zimmerman, M.D. Weill Cornell Medical College The Methodist Hospital Houston, Texas Objectives Review application of protocols
More informationNON-INVASIVE VENTILATION. Jason C. Brainard, MD Assistant Professor Department of Anesthesiology
NON-INVASIVE VENTILATION Jason C. Brainard, MD Assistant Professor Department of Anesthesiology Objectives Overview of Non-Invasive Ventilation Discuss Specific Indications for Non-Invasive Ventilation
More informationThe earliest efforts to employ noninvasive ventilation (NIV) or pressure
ACUTELY DECOMPENSATED HEART FAILURE Role of Noninvasive Ventilation in the Management of Acutely Decompensated Heart Failure Edward A. Panacek, MD, MPH, J. Douglas Kirk, MD Division of Emergency Medicine,
More informationYear in review: mechanical ventilation
Year in review: mechanical ventilation Leo Heunks, MD, PhD Pulmonary and Critical Care Physician Dept of Critical Care Intensivisten dagen 2013 Disclosures Maquet (NAVA catheters, travel fee, speakers
More informationRES Non-Invasive Positive Pressure Ventilation Guideline Page 1 of 9
Page 1 of 9 Scope: Respiratory Care Department, Physicians, Advanced Nurse Practitioners (APRN), Physician Assistants (PA) Population: Patients receiving rescue or non-rescue non-invasive positive pressure
More informationOriginal Article COPD and Hospital Stay Pak Armed Forces Med J 2014; 64 (1): 46-50. Ahmed Raza, Mahmood Iqbal Malik*, Yousaf Jamal**
Original Article COPD and Hospital Stay Pak Armed Forces Med J 2014; 64 (1): 46-50 COMPARISON OF NIPPV WITH STANDARD TREATMENT IN PATIENTS WITH ACUTE EXACERBATIONS OF COPD IN TERMS OF IMPROVEMENT IN ABGS
More informationLa Ventilazione non-invasiva: questioni aperte... Andrea Bellone UOC di Pronto Soccorso-OBI-Medicina per Acuti Azienda Ospedaliera Sant'Anna Como
La Ventilazione non-invasiva: questioni aperte... Andrea Bellone UOC di Pronto Soccorso-OBI-Medicina per Acuti Azienda Ospedaliera Sant'Anna Como Ruolo del medico di PS 1) Diagnostica differenziale 2)
More informationCommon Ventilator Management Issues
Common Ventilator Management Issues William Janssen, M.D. Assistant Professor of Medicine National Jewish Health University of Colorado Denver Health Sciences Center You have just admitted a 28 year-old
More informationBIPAP Synchrony TM AVAPS
BIPAP Synchrony TM AVAPS Product Presentation V1.6 Contents Home NIV Solution introduction BiPAP Technology and Auto-Trak algorithm Consensus conference, Chest 1999 The AVAPS algorithm The AVAPS settings
More informationAirway Pressure Release Ventilation (APRV) for the Treatment of Severe Life-Threatening ARDS in a Morbidly Obese Patient
Review Crit Care & Shock (2008) 11 : 132-136 Airway Pressure Release Ventilation (APRV) for the Treatment of Severe Life-Threatening ARDS in a Morbidly Obese Patient Amyn Hirani, Rodrigo Cavallazzi, Anastasia
More information5/30/2014 OBJECTIVES THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM. Disclosure
THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM Ona Fofah, MD FAAP Assistant Professor of Pediatrics Director, Division of Neonatology Department of Pediatrics Rutgers- NJMS, Newark OBJECTIVES
More informationCardiogenic shock: invasive and non-invasive monitoring John T. Parissis Attikon University Hospital Athens, Greece
Cardiogenic shock: invasive and non-invasive monitoring John T. Parissis Attikon University Hospital Athens, Greece Disclosures: Research grants by Abbott USA and Orion-Pharma as a member of steering committee
More information06/05/2014. Respiratory Medicine Professor Colin Sullivan
1 Respiratory Medicine Professor Colin Sullivan 2 3 Modalidade utilizada em 90% dos casos. Thorax 1998 53: 416-18 Lancet 1999 353:2100-05 AJRCCM 2004 169:156-62 AJRCCM 161:857-5-859, 2000 Chest 2005; 128:1304-1309
More informationMechanical Ventilation for Dummies Keep It Simple Stupid
Mechanical Ventilation for Dummies Keep It Simple Stupid Indications Airway Ventilation failure (CO2) Hypoxia Combination Airway obstruction Inability to protect airway Hypoxia (PaO 2 < 50) Hypercapnia
More informationAT HOME DR. D. K. PILLAI MUG @ UOM
NON - INVASIVE VENTILATION AT HOME DR. D. K. PILLAI 07.09.2011 MUG @ UOM In the beginning came. OSA (HS) 1. CPAP for OSAHS (Obstructive Sleep Apnoea Hypopnoea Syndrome) 2 NIPPV 2. NIPPV (Non
More informationTRANSPORT OF CRITICALLY ILL PATIENTS
TRANSPORT OF CRITICALLY ILL PATIENTS Introduction Inter-hospital and intra-hospital transport of critically ill patients places the patient at risk of adverse events and increased morbidity and mortality.
More informationEpinephrine in CPR. The 5 Most Important EMS Articles EAGLES 2014. Epi vs No-Epi Take Homes 2/28/2014. VF/VT (1990 Pairs) Epi vs No-Epi
The 5 Most Important EMS Articles EAGLES 214 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN nephrine in CPR VF/VT
More informationThe 5 Most Important EMS Articles EAGLES 2014
The 5 Most Important EMS Articles EAGLES 2014 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN VanderbiltEM.com
More informationFrom AARC Protocol Committee; Subcommittee Adult Critical Care Version 1.0a (Sept., 2003), Subcommittee Chair, Susan P. Pilbeam
AARC - ADULT MECHANICAL VENTILATOR PROTOCOLS 1. Guidelines for Using Ventilator Protocols 2. Definition of Modes and Suggestions for Use of Modes 3. Adult Respiratory Ventilator Protocol - Guidelines for
More informationFor every breath he takes. Trilogy200 ventilator s added sensitivity lets you breathe easier knowing your patients are where they belong home.
For every breath he takes Trilogy200 ventilator s added sensitivity lets you breathe easier knowing your patients are where they belong home. Sensitive to your patients needs Trilogy200, a portable life-support
More informationINTRODUCING RESMED S. Home NIV Solutions. S9 VPAP ST-A with ivaps S9 VPAP ST. Why choose average when you can choose intelligent?
INTRODUCING RESMED S Home NIV Solutions S9 VPAP ST-A with ivaps S9 VPAP ST Why choose average when you can choose intelligent? Now you can provide intelligent air through ResMed s intelligent Volume-Assured
More informationNew Tools of the Trade for Implementing a Successful NIV Program. Robert S. Campbell, RRT FAARC National Ventilation Specialist Philips Healthcare
New Tools of the Trade for Implementing a Successful NIV Program Robert S. Campbell, RRT FAARC National Ventilation Specialist Philips Healthcare Course Objectives Review indications and complications
More informationRuchika D. Husa, MD, MS Assistant t Professor of Medicine in the Division of Cardiology The Ohio State University Wexner Medical Center
Modified Early Warning Score (MEWS) Ruchika D. Husa, MD, MS Assistant t Professor of Medicine i in the Division of Cardiology The Ohio State University Wexner Medical Center MEWS Simple physiological scoring
More informationIntroduction Hypothesis Methods Results Conclusions Figure 11-1: Format for scientific abstract preparation
ABSTRACT AND MANUSCRIPT PREPARATION / 69 CHAPTER ELEVEN ABSTRACT AND MANUSCRIPT PREPARATION Once data analysis is complete, the natural progression of medical research is to publish the conclusions of
More informationNoninvasive Ventilation A Primer for Medical Center Administrators
Noninvasive Ventilation A Primer for Medical Center Administrators Adam Seiver, MD, PhD, MBA, FACS, FCCM Vice President and Chief Medical Officer Hospital Respiratory Care, Philips Healthcare Medical Director,
More informationCONSENSUS CONFERENCE CONSENSUS CONFERENCE ORGANIZATION
CONSENSUS CONFERENCE Réanimation 2001 ; 10 : 112-25 2001 Éditions scientifiques et médicales Elsevier SAS. Tous droits réservés S1164675600000876/FLA Noninvasive positive pressure ventilation in acute
More informationProving Respiratory Therapy value in the Affordable Care Pay Structure
Proving Respiratory Therapy value in the Affordable Care Pay Structure The Curve 2 2 No Margin No Mission (FFS) Outcomes 3 * 2001 study in five states found that medical debt contributed to 46.2% of all
More informationIrish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy
31 st Irish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy 1 Introduction Chronic obstructive pulmonary disease (COPD) is an important disease for patients, the health
More informationNon-invasive ventilation in acute respiratory failure
192 BTS GUIDELINE Non-invasive ventilation in acute respiratory failure British Thoracic Society Standards of Care Committee... Thorax 2002;57:192 211 Members of BTS Standards of Care Committee: S Baudouin,
More informationDRG 475 Respiratory System Diagnosis with Ventilator Support. ICD-9-CM Coding Guidelines
DRG 475 Respiratory System Diagnosis with Ventilator Support ICD-9-CM Coding G The below listed g are not inclusive. The coder should refer to the applicable Coding Clinic g for additional information.
More informationAirway Pressure Release Ventilation
Page: 1 Policy #: 25.01.153 Issued: 4-1-2006 Reviewed/ Revised: Section: 10-11-2006 Respiratory Care Airway Pressure Release Ventilation Description/Definition Airway Pressure Release Ventilation (APRV)
More informationPhilips Respironics CEU Programs
Philips Respironics CEU Programs Sleep therapy presentations Interface and Therapy Options Overview Review the selection and fit of three mask categories: minimal contact or pillow masks, nasal masks,
More informationMECHINICAL VENTILATION S. Kache, MD
MECHINICAL VENTILATION S. Kache, MD Spontaneous respiration vs. Mechanical ventilation Natural spontaneous ventilation occurs when the respiratory muscles, diaphragm and intercostal muscles pull on the
More informationD-370-2010. Non-Invasive Ventilation (NIV) with the Oxylog 2000 plus and Oxylog 3000 plus
D-370-2010 Non-Invasive Ventilation (NIV) with the Oxylog 2000 plus and Oxylog 3000 plus 02 NON INVASIVE VENTILATION WARNING This booklet is not a substitute for the Instructions for Use of the Oxylog
More informationThe use of non-invasive ventilation for life-threatening asthma attacks: Changes in the need for intubationresp_1766 714..720
ORIGINAL ARTICLE The use of non-invasive ventilation for life-threatening asthma attacks: Changes in the need for intubationresp_1766 714..720 KIMIHIKO MURASE, 1 KEISUKE TOMII, 1 KAZUO CHIN, 2 TOMOMASA
More informationNoninvasive ventilation (NIV),
Concise Definitive Review R. Phillip Dellinger, MD, FCCM, Section Editor Noninvasive ventilation in acute respiratory failure Nicholas S. Hill, MD; John Brennan, MD; Erik Garpestad, MD; Stefano Nava, MD
More informationRecommendations: Other Supportive Therapy of Severe Sepsis*
Recommendations: Other Supportive Therapy of Severe Sepsis* K. Blood Product Administration 1. Once tissue hypoperfusion has resolved and in the absence of extenuating circumstances, such as myocardial
More informationSARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY TITLE: NON-INVASIVE POSITIVE PRESSURE (NPPV) VENTILATION (CPAP/BIPAP) Job Title of Reviewer: EFFECTIVE DATE: REVISED DATE: POLICY TYPE: Director, Respiratory
More informationTitration protocol reference guide
Titration protocol reference guide Description Page Titration protocol goals 4 CPAP protocol CPAP protocol 6 CPAP titration protocol 7 CPAP reimbursement criteria 8 BiPAP S protocol BiPAP S protocol 10
More informationGuidelines for Standards of Care for Patients with Acute Respiratory Failure on Mechanical Ventilatory Support
Guidelines for Standards of Care for Patients with Acute Respiratory Failure on Mechanical Ventilatory Support Copyright by the SOCIETY OF CRITICAL CARE MEDICINE These guidelines can also be found in the
More informationYear in Review 2012 Intensive Care. J.G. van der Hoeven j.vanderhoeven@ic.umcn.nl or hahoe@mac.com www.intensivistenopleiding.nl
Year in Review 2012 Intensive Care J.G. van der Hoeven j.vanderhoeven@ic.umcn.nl or hahoe@mac.com www.intensivistenopleiding.nl ARDS Difficult weaning Fluid therapy Sepsis Subjects Berlin definition Bilateral
More informationImplementing a Prehospital 12-Lead Program
Implementing a Prehospital 12-Lead Program Corey M. Slovis, M.D. Professor and Chairman Department of Emergency Medicine Vanderbilt University Medical Center Medical Director, Metro Nashville Fire Department
More informationCENTER FOR KLINISKE RETNINGSLINJER - CLEARINGHOUSE
Bilag 2 - Søgematricer Medline Træning amyotrophic lateral upper motor neuron disease Amyotrophic lateral sclerosis [MeSH] physical fitness [MeSH] physical training exercise therapy [MeSH] Rehabilitation
More informationColorado Cardiac Conference: 2 nd teaching workshop. Proactive Respiratory Therapy in postoperative Cardiac Patients
Colorado Cardiac Conference: 2 nd teaching workshop Proactive Respiratory Therapy in postoperative Financial Disclosures Donald Fritz, RT Jerrold Judd, RT No relevant financial relationships with any commercial
More informationPerioperative Management of Patients with Obstructive Sleep Apnea. Kalpesh Ganatra,MD Diplomate, American Board of Sleep Medicine
Perioperative Management of Patients with Obstructive Sleep Apnea Kalpesh Ganatra,MD Diplomate, American Board of Sleep Medicine Disclosures. This activity is supported by an education grant from Trivalley
More informationCongenital Diaphragmatic Hernia. Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate
Congenital Diaphragmatic Hernia Manuel A. Molina, M.D. University Hospital at Brooklyn SUNY Downstate Congenital Diaphragmatic Hernias Incidence 1 in 2000 to 5000 live births. 80% in the left side, 20%
More informationNurses and Respiratory Therapists Working Together for Safe Alarm Systems Management
Nurses and Respiratory Therapists Working Together for Safe Alarm Systems Management May 11, 2015 9/25/2013 1 AAMI Foundation Vision: To drive the safe adoption and use of healthcare technology Visit our
More informationCritical Care Therapy and Respiratory Care Section
Category: Section: Title: Critical Care Therapy and Respiratory Care Section Policy #: 03 Revised: 5/02 1.0 DESCRIPTION Clinical Ventilator Management Invasive and Noninvasive Positive Pressure Ventilation
More informationMECHANICAL VENTILATION: AN OVERVIEW
MECHANICAL VENTILATION: AN OVERVIEW by Kevin T. Martin BVE, RRT, RCP V7117 HC 04 RC Educational Consulting Services, Inc. P.O. Box 1930, Brockton, MA 02303-1930 (800) 441-LUNG / (877) 367-NURS www.rcecs.com
More informationINTERDISCIPLINARY CLINICAL MANUAL Policy/ Procedure
INTERDISCIPLINARY CLINICAL MANUAL Policy/ Procedure TITLE: Non Invasive Positive NUMBER: CC 45-072 Pressure Ventilation Date Issued: October 2011 Page 1 of 13 Applies To: Respiratory Therapy and Nursing
More informationOxygenation and Oxygen Therapy Michael Billow, D.O.
Oxygenation and Oxygen Therapy Michael Billow, D.O. The delivery of oxygen to all body tissues is the essence of critical care. Patients in respiratory distress/failure come easily to mind as the ones
More informationACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) S. Agarwal, MD, S. Kache MD
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) S. Agarwal, MD, S. Kache MD Definition ARDS is a clinical syndrome of lung injury with hypoxic respiratory failure caused by intense pulmonary inflammation that
More informationComparison of the Rate of Improvement in Gas Exchange between Two High Frequency Ventilators in a Newborn Piglet Lung Injury Model
Comparison of the Rate of Improvement in Gas Exchange between Two High Frequency Ventilators in a Newborn Piglet Lung Injury Model Kurt Gillette, MD, San Antonio Military Medical Center Background: High
More informationThe Berlin definition of Severe ARDS includes assessment of which of the following?
2013 ACS Critical Care Update ARDS, Ventilators MCQs August, 2013 (Berlin Definition of ARDS Question 1) The Berlin definition of Severe ARDS includes assessment of which of the following? A. Oxygenation:
More informationETCO2 Monitoring: Riding the Wave! Disclosure 4/11/2013
ETCO2 Monitoring: Riding the Wave! Debbie Fox, MBA, RRT-NPS, FAARC Director, Respiratory Care Wesley Medical Center Disclosure I have no financial conflicts to disclose. I have participated in focus groups
More informationNIV in non CPE, non-copd, non-neuromuscular patients
NIV in non CPE, non-copd, non-neuromuscular patients Giorgio Iotti Anestesia e Rianimazione 2 Pavia Italia Missioni ECMOteam Pavia 2009/2011 18 4 2 Trasporto con ECMO senza ECMO ALI/ARDS Immunocompetent
More informationMichigan Adult Cardiac Protocols CARDIAC ARREST GENERAL. Date: May 31, 2012 Page 1 of 5
Date: May 31, 2012 Page 1 of 5 Cardiac Arrest General This protocol should be followed for all adult cardiac arrests. Medical cardiac arrest patients undergoing attempted resuscitation should not be transported
More informationKING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTRE (GEN. ORG.) NURSING AFFAIRS. Scope of Service PEDIATRIC INTENSIVE CARE UNIT (PICU)
PICU-Jan.2012 Page 1 of 7 Number of Beds: 18 Nurse Patient Ratio: 1:1-2 : The Pediatric Intensive Care Unit (PICU) provides 24 hour intensive nursing care for patients aged neonate through adolescence.
More informationBergen Community College Division of Health Professions Department of Respiratory Care RSP-231, Respiratory Care Clinical Externship IV
Date of Most Recent Syllabus Revision: August 2014 Semester and Year: Fall 2014 Bergen Community College Division of Health Professions Department of Respiratory Care RSP-231, Respiratory Care Clinical
More informationNeurally Adjusted Ventilatory Assist: NAVA for Neonates
Neurally Adjusted Ventilatory Assist: NAVA for Neonates Robert L. Chatburn, MHHS, RRT-NPS, FAARC Research Manager Respiratory Institute Cleveland Clinic Professor Department of Medicine Lerner College
More informationHow To Treat A Patient With A Lung Condition
NHS FORTH VALLEY BIPAP Guideline Date of First Issue 27 / 10 / 2010 Approved 27 / 10 / 2010 Current Issue Date 27 / 10 / 2010 Review Date 27 / 10 / 2012 Version Version 1.00 EQIA Yes 27 / 10 / 2010 Author
More informationThe Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy
The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy Cindy Goodrich RN, MS, CCRN Content Description Sepsis is caused by widespread tissue injury and systemic inflammation resulting
More informationTrilogy200. Proximal pressure line. Exhalation valve line. Quick start guide. Overview. Circuit set-up. Set-up screen. Prescription set-up
Trilogy200 Proximal pressure line Exhalation valve line Quick start guide 1 2 3 4 Overview Circuit set-up Set-up screen Prescription set-up 1 Overview 4 Porting block Detachable battery Air inlet and grey
More informationUniversity of Kansas. Respiratory Care Education
University of Kansas Respiratory Care Education What is Respiratory Care? Respiratory Care is the health profession that specializes in the promotion of optimum cardiopulmonary function and health Respiratory
More informationAVAPS-AE Auto-titration Mode of Noninvasive Ventilation. Monique Hom Sr. Clinical Education Manager HHS
AVAPS-AE Auto-titration Mode of Noninvasive Ventilation Monique Hom Sr. Clinical Education Manager HHS AVAPS-AE: Why do we need it? 3 AVAPS-AE AVAPS-AE is an Auto-titration Mode of Noninvasive ventilation
More information240- PROBLEM SET INSERTION OF SWAN-GANZ SYSTEMIC VASCULAR RESISTANCE. Blood pressure = f(cardiac output and peripheral resistance)
240- PROBLEM SET INSERTION OF SWAN-GANZ 50 kg Pig Rt Jugular 0 cm Rt Atrium 10 cm Rt ventricle 15 cm Wedge 20-25 cm SYSTEMIC VASCULAR RESISTANCE Blood pressure = f(cardiac output and peripheral resistance)
More informationNORTH WALES CRITICAL CARE NETWORK
NORTH WALES CRITICAL CARE NETWORK LEVELS OF CRITICAL CARE FOR ADULT PATIENTS Throughout the work of the North Wales Critical Care Network reference to Levels of Care for the critically ill are frequently
More informationOxygenation. Chapter 21. Anatomy and Physiology of Breathing. Anatomy and Physiology of Breathing*
Oxygenation Chapter 21 Anatomy and Physiology of Breathing Inspiration ~ breathing in Expiration ~ breathing out Ventilation ~ Movement of air in & out of the lungs Respiration ~ exchange of O2 & carbon
More informationTitration protocol reference guide
Titration protocol reference guide Titration protocol reference guide Description Page Patient types 3 Titration protocol goals 4 CPAP CPAP protocol 5-6 auto CPAP auto CPAP protocol 7-8 BiPAP S BiPAP S
More informationEdwards FloTrac Sensor & Edwards Vigileo Monitor. Understanding Stroke Volume Variation and Its Clinical Application
Edwards FloTrac Sensor & Edwards Vigileo Monitor Understanding Stroke Volume Variation and Its Clinical Application 1 Topics System Configuration Pulsus Paradoxes Reversed Pulsus Paradoxus What is Stroke
More informationProtocols for Early Extubation After Cardiothoracic Surgery
Protocols for Early Extubation After Cardiothoracic Surgery AATS / STS CT Critical Care Symposium April 27, 2014 Toronto, Ontario Nevin M. Katz, M.D. Johns Hopkins University Foundation for the Advancement
More informationPAP Therapy Devices: Delivering the Right Therapy To The Right Patient. Ryan Schmidt, BS,RRT Clinical Specialist Philips Respironics
PAP Therapy Devices: Delivering the Right Therapy To The Right Patient Ryan Schmidt, BS,RRT Clinical Specialist Philips Respironics Conflict of Interest Disclosure(s) I do not have any potential conflicts
More informationUnderstanding Hypoventilation and Its Treatment by Susan Agrawal
www.complexchild.com Understanding Hypoventilation and Its Treatment by Susan Agrawal Most of us have a general understanding of what the term hyperventilation means, since hyperventilation, also called
More informationHigh-Frequency Oscillatory Ventilation
High-Frequency Oscillatory Ventilation Arthur Jones EdD, RRT Learning Objectives Describe the indications and rationale and monitoring for HFOV. Identify HFOV settings and describe the effects of their
More informationAmerican Thoracic Society
American Thoracic Society International Consensus Conferences in Intensive Care Medicine: Noninvasive Positive Pressure Ventilation in Acute Respiratory Failure ORGANIZED JOINTLY BY THE AMERICAN THORACIC
More informationVentilation Perfusion Relationships
Ventilation Perfusion Relationships VENTILATION PERFUSION RATIO Ideally, each alveolus in the lungs would receive the same amount of ventilation and pulmonary capillary blood flow (perfusion). In reality,
More informationRespiratory Care. A Life and Breath Career for You!
Respiratory Care A Life and Breath Career for You! Respiratory Care Makes a Difference At 9:32 am, Lori Moreno brought a newborn baby struggling to breathe back to life What have you accomplished today?
More informationPULMONARY PHYSIOLOGY
I. Lung volumes PULMONARY PHYSIOLOGY American College of Surgeons SCC Review Course Christopher P. Michetti, MD, FACS and Forrest O. Moore, MD, FACS A. Tidal volume (TV) is the volume of air entering and
More informationSouthwark Clinical Commissioning Group Lambeth Clinical Commissioning Group
Getting the Vision Right: A multi-disciplinary approach to providing integrated care for respiratory patients Dr Noel Baxter, GP NHS Southwark CCG Dr Irem Patel, Integrated Consultant Respiratory Physician
More informationVASOPRESSOR AGENTS IN SEPTIC SHOCK
VASOPRESSOR AGENTS IN SEPTIC SHOCK Daniel De Backer Head Dept Intensive Care, CHIREC hospitals, Belgium Professor of Intensive Care, Université Libre de Bruxelles President European Society of Intensive
More informationWhat is the Future of Epinephrine in Cardiac Arrest? Pros and Cons
What is the Future of Epinephrine in Cardiac Arrest? Pros and Cons Melissa L. Thompson Bastin, PharmD., BCPS Komal A. Pandya, PharmD., BCPS 0 Presenter Disclosure Information Melissa L. Thompson Bastin,
More informationAHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings
AHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings Resuscitation step Recommendations (2005) Recommendations (2010) Comments/LOE
More informationRestoring a good night s sleep
Restoring a good night s sleep Products for diagnosing, treating, and monitoring sleep apnea Sleep apnea solutions A good night s sleep is an essential part of healthy living, but for patients diagnosed
More informationHospital of the University of Pennsylvania Physician Practice Guideline
Page 1 of 5 KEY WORDS: Ventilator Respirator Weaning Extubation Liberation PURPOSE: To facilitate the liberation of patients from mechanical ventilation and provide a consistent approach to the ventilator
More informationNoninvasive positive pressure ventilation in acute asthmatic attack
Eur Respir Rev 2010; 19: 115, 39 45 DOI: 10.1183/09059180.00006109 CopyrightßERSJ Ltd 2010 REVIEW Noninvasive positive pressure ventilation in acute asthmatic attack A. Soroksky*, E. Klinowski*, E. Ilgyev*,
More informationMichael R. Pinsky, M.D., C.M., Dr.h.c., FCCP, MCCM Professor of Critical Care Medicine, Bioengineering, Anesthesiology, Cardiovascular Diseases, and
Michael R. Pinsky, M.D., C.M., Dr.h.c., FCCP, MCCM Professor of Critical Care Medicine, Bioengineering, Anesthesiology, Cardiovascular Diseases, and Clinical & Translational Sciences, Vice Chair for Academic
More informationObstructive Sleep Apnea and Sleep Disorders in All Age Groups Treatment
Obstructive Sleep Apnea and Sleep Disorders in All Age Groups Treatment W. McD. Anderson, M.D. Medical Director, Tampa General Hospital Sleep Center Professor of Medicine, USF College of Medicine Program
More informationMECHANICAL VENTILATION FOR ACUTE RESPIRATORY FAILURE
Course on MECHANICAL VENTILATION FOR ACUTE RESPIRATORY FAILURE Course Directors: Prof. Stefano Nava Chief of Respiratory Unit Alma Mater Studiorum University of Bologna Policlinico S. Orsola-Malpighi,
More informationPediatric Airway Management
Pediatric Airway Management Dec 2003 Dr. Shapiro I., PICU Adult Chain of Survival EMS CPR ALS Early Defibrillation Pediatric Chain of Survival Prevention CPR EMS ALS Out-of-Hospital Cardiac Arrest SIDS
More informationPulmonary Hypertension in Sickle Cell Disease. Jorge Ramos Hematology Fellows Conference June 28, 2013
Pulmonary Hypertension in Sickle Cell Disease Jorge Ramos Hematology Fellows Conference June 28, 2013 Patient Presentation 28F with SCD, genotype SS. Presented to UWMC ER with 1 month progressive DOE and
More informationLow-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity
Low-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Disclosures : None 77-year-old woman, mild dyspnea
More informationGuideline for the use of Non-Invasive Ventilation (NIV) TCP 180
Guideline for the use of Non-Invasive Ventilation (NIV) CROSS REFERENCE Progress/date of approval This Strategy/ Policy should be read in conjunction with: Mental Capacity Act Policy -TCP 199 June 2009
More informationPlatelet Function Testing vs Genotyping : Focus on Pharmacogenomics of Clopidogrel. Kiyuk Chang, M.D., Ph.D.
Platelet Function Testing vs Genotyping : Focus on Pharmacogenomics of Clopidogrel Kiyuk Chang, M.D., Ph.D. Cardiovascular Center & Cardiology Division Seoul St. Mary s Hospital The Catholic University
More informationTreatment of cardiogenic shock
ACUTE HEART FAILURE AND COMORBIDITY IN THE ELDERLY Treatment of cardiogenic shock Christian J. Wiedermann, M.D., F.A.C.P. Associate Professor of Internal Medicine, Medical University of Innsbruck, Austria
More informationWeaning the Unweanable
Weaning the Unweanable Gerald W. Staton, Jr, MD Professor of Medicine Pulmonary & Critical Care Medicine Emory University School of Medicine Atlanta, GA gerald.staton@emory.edu Disclosures Pulmonary Program
More informationInflammatory or cardiogenic lung edema? It does matter!
Inflammatory or cardiogenic lung edema? It does matter! Dr Xavier MONNET Medical Intensive Care Unit Bicêtre Hospital FRANCE Conflict of interest Inflammatory or cardiogenic lung edema? It does matter!
More information6 Easy Steps to ABG Analysis
6 Easy Steps to ABG Analysis E-Booklet David W. Woodruff, MSN, RN- BC, CNS, CMSRN, CEN 571 Ledge Road, Macedonia, OH 44056 Telephone (800) 990-2629 Fax (800) 990-2585 1997-2012 Ed4Nurses, Inc. All rights
More informationDUAL ANTIPLATELET THERAPY. Dr Robert S Mvungi, MD(Dar), Mmed (Wits) FCP(SA), Cert.Cardio(SA) Phy Tanzania Cardiac Society Dar es Salaam Tanzania
DUAL ANTIPLATELET THERAPY Dr Robert S Mvungi, MD(Dar), Mmed (Wits) FCP(SA), Cert.Cardio(SA) Phy Tanzania Cardiac Society Dar es Salaam Tanzania DUAL ANTIPLATELET THERAPY (DAPT) Dual antiplatelet regimen
More informationThe Swedish approach: Quality Assurance with Clinical Quality Registries the RIKS-HIA example
The Swedish approach: Quality Assurance with Clinical Quality Registries the RIKS-HIA example Ulf Stenestrand, MD, PhD Department of Cardiology University Hospital Linköping Chairman RIKS-HIA Register
More information