Discover and read the best of Twitter Threads about #SoMe4MV

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#POCUS y #SoMe4MV en #PedsICU
🔊en Ventilación Mecánica 🫁

Abro hilo, iniciamos, y abiertos los comentarios:
Esta información tuvimos el gusto de compartirla en el IV Curso Internacional de Medicina Intensiva Pediátrica dentro del XVI Congreso Internacional de Medicina Intensiva organizado por la @sopemi_org.
Gracias por la invitación. Ahora si, entremos en materia.
Los objetivos planteados en tres puntos:
Relacionar el Ultrasonido Pulmonar (LUS) y la Ventilación Mecánica (VM).
Conocer guías y monitoreo que nos ofrece el POCUS en VM y mencionar elementos evaluables por LUS.
Read 56 tweets
Here is the #PedsICU #BestOf2020 collection.
Jointly chosen by
@Dr_Hari_Krishna @sgdambrauskas and myself
Pubmed collection 40 articles:…
Infographic (clickable PDF) in English:
#PedsCICU #NeuroPICU
This will be a bilingual tweetorial in Spanish/English!
Infographics are available in both languages in Tweet #1

El hilo será en Español/Inglés. El resumen infográfico está disponible en los dos idiomas en el primer Tweet
1/What are the outcomes that matter to children, to families and to #researchers/clinicians? @ericka_fink et al & @PostPICU_PALISI investigators identified COS using a delphi process. @CritCareMed Developmental and functional outcomes were important.
Read 44 tweets
Llegó colección de lo #Mejor2020 en #PedsICU &
@Dr_Hari_Krishna 🇬🇧@MiguelrrMD 🇪🇸 @sgdambrauskas 🇺🇾

Versión infográfico español:
Version inglés:

#SoMe4MV #neuroPICU #delirium #PedsCICU
English #BestOf2020
The #Bestof2020 #PedsICU pubmed collection will also be available in the FREE #PICCHub app (sponsored by @PICSociety) as the latest monthly #PICUJournalwatch collection:
Download links: Android:…
3/ La FUNCIÓN como nuevo paradigma
@ericka_fink et al POST #PedsICU investigators & @PALISInet hicieron consenso Delphi
Qué es lo importante como resultados al alta #PedsICU?

En @CritCareMed lo que encontraron con precioso infogràfico
Read 42 tweets
Here is the #PedsICU #BestOf2020 collection.
Jointly chosen by @Dr_Hari_Krishna @sgdambrauskas @miguelrrMD
Pubmed collection 40 articles:…
Infographic (clickable PDF) in English:
#PedsCICU #NeuroPICU
The #Bestof2020 #PedsICU pubmed collection will also be available in the FREE #PICCHub app (sponsored by @PICSociety) as the latest monthly #PICUJournalwatch collection:
Download links: Android:…
.@sgdambrauskas and @MiguelrrMD will be simultaneously sharing their thoughts about the #PedsICU #Bestof2020 collection in a tweetorial.
Read 40 tweets
Interesting issue in mechanical ventilation of #COVID19 patients, each one here after >10 days of mechanical ventilation.

How might we monitor for development of this? Time to pay attention to resistance, oft neglected in the age of COVID #ARDS...

#tweetorial #SoMe4MV
First step is to examine the flow waveform. In this case a patient in volume control, to observe how passive expiration is changed by changing time constant.

More on time constants here:…
A faster time constant is associated with decreased compliance (increased elastic recoil). The opposite is seen with airway resistance.

In these cases we often see the expiratory phase on the flow diagram *not* return to baseline before the next inspiration is initiated
Read 9 tweets
All "Mechanical ventilation for dummies" videos in one thread so we can have a bit of discussion around each topic. All questions encouraged, will try to answer to the best of my knowledge! @lberto_Medina #SoMe4MV #PedsICU
I will dedicate each video to a friend and ask them to help me with the discussion (no pressure). We are learning together, and we are a team!
1. Lung simulator. Here we learn how to build a low cost simulation device to help with our teaching. And who will be better to discuss simulation than my colleague @davidgrantsim!
Read 9 tweets
Time for answers! As many of you surmised, this patient is not happy with the current settings.

Also, the ventilator *might* be lying to you about its mode... #SoMe4MV
The most obvious issue here is flow starvation. The patient's effort suggests they want a much higher flow and/or Vt. Compare the waveform to the idealized VC waveform of a passive patient. The flow goes below the PEEP baseline! Image
Not only is this uncomfortable, and probably deleterious, but it will lead you to believe your Ppeak and maybe your Pplat are lower than they actually are!

More on flow starvation here…
Read 14 tweets
Short #Tweetorial

How did we started with heated humified high flow nasal cannula in 🇺🇾 ?

Easy explanation of 3 #HHHFNC homemade models #HFNC devices?

(No COI to declare)

#PedsICU #SoMe4MV #historyofmedicine @WFPICCS
It is really easy.
You can get information of its uses and applications in this nice review in @respcare ▶️

This is basically the diagram 👇
So back in 2012 in our country we wanted to try some kind of respiratory support for the youngest infants in which interfases for #NIV was difficult.

SO we came up with an idea: What if we dismantle the old ventilators we do not use any more?

Like this ones 👇
Read 13 tweets

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