PPT-Optimizing Lung Protective Ventilation to Improve ARDS Outcomes

Brad Smith PhD University of Colorado Denver Anschutz Medical Campus Departments of Bioengineering and Pediatrics Background and Vision Background and Motivation Acute respiratory distress syndrome ARDS. Have we been killing our Patients?. Philip M. Hartigan, MD. Brigham & Women’s Hospital. Harvard Medical School. Case Report:. 54 y/o male. Smoking History. COPD. Persistent cough. CXR - Large RUL mass. Julia E. Linton. York College/ Wellspan Health Nurse Anesthesia Program. Objectives. Review patient case scenario. Review some basic principles of respiratory physiology. Describe indications for and complications with one-lung ventilation. Ananya Anne. Case . 64 y/o man with . pmh. of CHF, COPD, IDDM2, is sent from his nursing home with altered mental status. On presentation he is AAOX1 and follows some commands. His vitals are stable except for O2 sat which is 88%. On physical exam, there are some fine crackles to auscultation in the posterior lung fields. He has 1+ pitting edema in the lower extremities. JVP is not appreciable. His echocardiogram from one month prior shows an EF ~45%. His EKG is unchanged with no acute changes. . During General Endotracheal Anesthesia. . Valentyna. . Groelle. , RN, BSN, SRNA. Review the physiology of alveolar ventilation. Discuss pulmonary changes after induction of general . PRVC, MMV, VS, and ASV. By Joshua and Marissa . Lets review!!!. What are the 3 modes?. Review continued… . What are the 3 different breath types?. REVIEW!!. What is . PEEP?. Why is it used?. What do you need to be careful of when using . By:. Dr.behzad barekatain ,MD. Assistant professor of pediatrics. . Neonatologist. Isfahan university of medical scienses. Mechanical ventilation can be achieved through the use of intermittent . By: Yazmin Realivasquez. Stephen Huang . Jose Torres. What is ARDS?. ARDS is a respiratory condition characterized by hypoxemia, and stiff lungs, without mechanical ventilation most patients would die. ARDS represents a response to many different insults/injuries and evolves through different phases: alveolar capillary damage to lung resolution to a fibro-proliferative phase. The pulmonary epithelial and endothelial cellular damage is characterized by inflammation, apoptosis, necrosis and increased alveolar-capillary permeability, which lead to the development of alveolar edema. . . Valentyna. . Groelle. , RN, BSN, SRNA. Review the physiology of alveolar ventilation. Discuss pulmonary changes after induction of general . endotracheal anesthesia. Describe how to perform two major types of alveolar recruitment maneuvers. Defined as the impairment of the lung’s ability to maintain adequate oxygen and carbon dioxide homeostasis.. Respiratory Failure - Definition. PaO. 2. < 60 mm Hg. and/or. PaCO. 2. > 50 mm Hg. et al). Incidence 1.5 -7.5/ 100000 population. 28 day mortality 25 – 30%. 1. Diagnosis clinical. Differential. . diagnosis. . . LVF. Fluid overload. Mitral . stenosis. Lymphangitis. . carcinomatosis. on Alveolar Gas Concentration. 1. Dr. Syed Mohammad Zub. air. MBBS(KE) BS (PU) DHA (CCM) FWHO(UK) MBA;FACHE (US) M.PHIL (PHYSIOLOGY). Assist. Prof Physiology . KING EDWARD . MEDICAL. UNIVERSITY, Lahore.. Applications and use during airborne transportation. C. Simonsen. 1,2,3. , . S.M. . Magnúsdóttir. 4. , C. Lie. 1. , J.J. Andreasen. 2,3. , B. Kjærgaard. 1,2,4. 1.-. Royal . Danish Armed Forces Health . Multisystem failure and ARDS. Multisystem . failure. ARDS. pathology. clinical features. medical treatment. mechanical ventilation . physiotherapy. Predisposing factors. IV drug users (drug + access)…. Karrar. Nader AL-. Taie. Special complications . in . the ICU. Acute respiratory distress syndrome (ARDS):. Pneumothorax: . DVT. stress ulcer. Acute . Respiratory Distress Syndrome . (ARDS. ):. It is a state of acute diffuse alveolar damage characterized by increased capillary permeability, pulmonary edema and refractory hypoxia due to right to left shunting.