Discover and read the best of Twitter Threads about #mechanicalventilation
Most recents (23)
Early trigger/ reverse triggering & 1:1 entrainment 
Comparison with a normal mandatory breath
New to the ICU?
Osler's catalogue of modules is completely free, and you can even print off a certificate of completion for your records!
Here's 10 great modules to get you started
#intensivecare #intensivist #ICU #FOAMed #FOAMcc #medtwitter @CICMANZ @anzics @ANZCA @acemonline
Osler's catalogue of modules is completely free, and you can even print off a certificate of completion for your records!
Here's 10 great modules to get you started
#intensivecare #intensivist #ICU #FOAMed #FOAMcc #medtwitter @CICMANZ @anzics @ANZCA @acemonline
If your're going to do invasive procedures, you need to get the basics right
osler.app.link/CztXIRjyntb
osler.app.link/CztXIRjyntb
If you're new to mechanical ventilation, this will give you the basics
osler.app.link/dnoTmYYRkvb
#mechanicalventilation
osler.app.link/dnoTmYYRkvb
#mechanicalventilation
MAPSE in #IntensiveCare (with examples)🧵#FOAMcc #FOAMed #MedTwitter #Hemodynamic #POCUS #EchoFirst #CriticalCare
Take homes:
1⃣ Redefining "the hyperdynamic heart" with #MAPSE
2⃣ MAPSE is better than EF in the #ICU
3⃣ Linking MAPSE with supply/demand-ischemia
1/n
Take homes:
1⃣ Redefining "the hyperdynamic heart" with #MAPSE
2⃣ MAPSE is better than EF in the #ICU
3⃣ Linking MAPSE with supply/demand-ischemia
1/n
1⃣ Can MAPSE redefine "the hyperdynamic heart?
The term "hyperdynamic LV" - EF > 55% - is misleading. It has no relation to a hyperdyanmic circulation; SV/CO. Someone bleeding to death has a hyperdynamic heart, but the circulation is life-threatening hypodynamic.
2/n
The term "hyperdynamic LV" - EF > 55% - is misleading. It has no relation to a hyperdyanmic circulation; SV/CO. Someone bleeding to death has a hyperdynamic heart, but the circulation is life-threatening hypodynamic.
2/n
MAPSE is cardiac motion, and defining the hyperDYNAMIC heart as good cardiac motion makes perfect sense. Recent geometrical analysis of cardiac pumping shows that MAPSE is the main determinant of SV. Fig from @mugander: tinyurl.com/mxbfmcyk
Why?
3/n
Why?
3/n
Patient failing weaning on trachy?
Just do a bronchoscopy without positive pressure
Just do a bronchoscopy without positive pressure
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
SBT t-tube or PS
No one in the audience use t-tube anymore
SBT t-tube or PS
No one in the audience use t-tube anymore
Little support = little pregnant 😜
Respiratory load and respiratory capacity
What are the possibilities
Different acronym for same mode of ventilation
Can we have universal language for MV ?
Can we have universal language for MV ?
40 years of ECMO
What have change is understanding of MV
🫁 Focus on protection
🫁 Focus on protection
Next workshop :: Poes practical session. We have Nutrivent. By Prof Alain Mercat , Oriol Rica , GIACOMO Grasselli. #LIVES2022 #ventilation #mechanicalventilation @ESICM
Values depends on the pt but if Poes is -15 then patient effort is very high. And for THOSE WITHOUT Poes, if you have a CVP and CVP values or waveform dips significantly during inspiration then you know that the patient effort is ++++ and intra thoracic pressure swing +++
It’s insane we have a live model (happily reading a book) whilst having a oesophageal catheter inserted ! And also a explanted lung model.
Why we should use prone position
PROSEVA huge impact on mortality
Association is not causation
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
Impact of mechanical ventilation on 🧠
Prof. Jean-Daniel Chiche
Impact of mechanical ventilation on 🧠
Prof. Jean-Daniel Chiche
The crosstalk
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
63% develops diaphragm dysfunction just after 3 days of mechanical ventilation 🤯
63% develops diaphragm dysfunction just after 3 days of mechanical ventilation 🤯
Pathophysiology of diaphragm dysfunction
Proof of concept
Diaphragm protective ventilation
Diaphragm protective ventilation
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
Prof. Giacomo Grasselli on asses respiratory mechanics during assist mechanical ventilation
Prof. Giacomo Grasselli on asses respiratory mechanics during assist mechanical ventilation
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
@DrLeoHeunks on invasive ventilation in asthma / COPD
@DrLeoHeunks on invasive ventilation in asthma / COPD
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
Next Professore Massimo Antonelli on helmet ventilation
Next Professore Massimo Antonelli on helmet ventilation
First RCT
Mask NIV vs Helmet
Mask NIV vs Helmet
Better recruitment with helmet
Standard Oxygen, NIV, HFNC, CPAP ?
A metal ion orients SARS-CoV-2 mRNA to ensure accurate 2′-O methylation of its first nucleotide
» doi.org/10.1038/s41467…
The #SARSCoV2 #coronavirus is able to utilize the changes in metal ion concentrations to disguise itself in the human host body thus evading immune responses.
» doi.org/10.1038/s41467…
The #SARSCoV2 #coronavirus is able to utilize the changes in metal ion concentrations to disguise itself in the human host body thus evading immune responses.
Efficacy of #clarithromycin on #COVID19 pneumonia without oxygen administration; protocol for multicenter, open-label, randomized-controlled, 3-armed parallel group comparison, exploratory trial #CAMECOVID
» doi.org/10.1101/2021.0…
Japan Registry of Clinical Trials jRCTs071210011
» doi.org/10.1101/2021.0…
Japan Registry of Clinical Trials jRCTs071210011
The influence of #HLA genotype on the severity of #COVID19 infection
» doi.org/10.1111/tan.14…
A genetic link has been discovered explaining why some people catch #Covid but don't get sick. The gene is found three times as often in people who are #asymptomatic.
» doi.org/10.1111/tan.14…
A genetic link has been discovered explaining why some people catch #Covid but don't get sick. The gene is found three times as often in people who are #asymptomatic.
🔝5 Concerns about #SARSCoV2 #Biology: A Call to Pause, Deliberate, and Revise Policy─This review is intended both as a basic resource and to initiate an open and critical dialog about SARS-CoV-2 biology for an independent and public call to action. jjcouey.medium.com/5-concerns-abo…
Structural basis of ribosomal #frameshifting during translation of the #SARSCoV2 #RNA #genome
» doi.org/10.1126/scienc…
A unique feature of the SARS-CoV-2 genome controls protein synthesis and presents an "Achilles heel" of the virus.
» doi.org/10.1126/scienc…
A unique feature of the SARS-CoV-2 genome controls protein synthesis and presents an "Achilles heel" of the virus.
Brainstem neuropathology in two cases of #COVID19: #SARSCoV2 trafficking between #brain and #lung
» doi.org/10.1007/s00415…
Neuropathologic evidence strongly suggests that the pathophysiology of COVID-19 related respiratory failure includes a neurogenic component.
» doi.org/10.1007/s00415…
Neuropathologic evidence strongly suggests that the pathophysiology of COVID-19 related respiratory failure includes a neurogenic component.
Reducing #COVID19 #Airborne #Transmission Risks on #PublicTransportation Buses
» doi.org/10.1101/2021.0…
Wearing of #facemasks reduced the overall particle count released into the bus by an average of 50%, the dispersion distance by several feet and #aerosol particles by 84.36%.
» doi.org/10.1101/2021.0…
Wearing of #facemasks reduced the overall particle count released into the bus by an average of 50%, the dispersion distance by several feet and #aerosol particles by 84.36%.
🔝#SARSCoV2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis
» doi.org/10.1016/j.jacb…
#COVID19 can kill heart muscle cells, interfere with contraction. Details of how #coronavirus infects #heart: models of tissue damage may help develop potential therapies.
» doi.org/10.1016/j.jacb…
#COVID19 can kill heart muscle cells, interfere with contraction. Details of how #coronavirus infects #heart: models of tissue damage may help develop potential therapies.
High-content screening of coronavirus genes for innate immune suppression reveals enhanced potency of SARS-CoV-2 proteins
» doi.org/10.1101/2021.0…
196 protein products of seven coronaviruses: the genes encoded by #SARSCoV2 are generally more potent immune suppressors than others
» doi.org/10.1101/2021.0…
196 protein products of seven coronaviruses: the genes encoded by #SARSCoV2 are generally more potent immune suppressors than others
⚠️#Ocular #MRI Findings in Patients with Severe #COVID19: A Retrospective Multicenter Observational Study
» doi.org/10.1148/radiol…
All patients had nodules in the macular region, 8/9 (89%) had bilateral nodules, 2/9 (22%) had nodules outside the macular region. Screening needed.
» doi.org/10.1148/radiol…
All patients had nodules in the macular region, 8/9 (89%) had bilateral nodules, 2/9 (22%) had nodules outside the macular region. Screening needed.
⚠️🔝New-Onset #IgG #Autoantibodies in Hospitalized Patients with #COVID19
» doi.org/10.1101/2021.0…
An international team of researchers studying COVID-19 has made a startling and pivotal discovery: The virus appears to cause the body to make weapons to attack its own tissues.
» doi.org/10.1101/2021.0…
An international team of researchers studying COVID-19 has made a startling and pivotal discovery: The virus appears to cause the body to make weapons to attack its own tissues.
⚠️🔝Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance
» academic.oup.com/eurheartj/adva…
Damage to the heart found in more than half of #COVID19 patients discharged from hospital who show raised levels of troponin.
» academic.oup.com/eurheartj/adva…
Damage to the heart found in more than half of #COVID19 patients discharged from hospital who show raised levels of troponin.
О, я знаю, що ми зробимо. Ми замутимо тред про штучну вентиляцію легень. Для немедиків чи медиків-неспеціалістів. Тобто я замучу, а ви лайкайте і ретвітьте, бо хочется слави. Від кількості лайків тред залежати не буде.
Спеціалісти - вибачайте за неточності, буду спрощувати.
Спеціалісти - вибачайте за неточності, буду спрощувати.
Основи основ: дихальні шляхи (ДШ) поділяються на верхні та нижні і складаються з порожнин носа, рота, глотки, гортані, трахеї та бронхів, що розгалуджуться 23-ма порядками у легенях. Через ДШ повітря потрапляє до цих самих легень, де відбувається наступний етап - газообмін.
Ось цей обмін повітрям з навколишнім середовищем і називається вентиляцією. Природня вентиляція (спонтанне дихання) - це те, що робимо ми з вами прямо зараз (ну, більшість із нас, я сподіваюсь). Коли воно з якихось причин неможливе, в гру вступає ВОНА - штучна вентиляція легень.
UTI-Club #3: lesión pulmonar inducida por la ventilación mecánica: VILI #tweetorial
interconsulta.online/uti-club-3-les…
#TuitMédico #MedTwitter #FOAMed #FOAMcc #MedEd #UTI #ICU #MechanicalVentilation #VIL
1/
👩🦱 55a
⌨️POP hemicolectomía (CA Colon). 3 hs de cirugía, sin complicaciones
interconsulta.online/uti-club-3-les…
#TuitMédico #MedTwitter #FOAMed #FOAMcc #MedEd #UTI #ICU #MechanicalVentilation #VIL
1/
👩🦱 55a
⌨️POP hemicolectomía (CA Colon). 3 hs de cirugía, sin complicaciones
2/
Ingresa a UTI extubada, sin requerimientos de vasopresores.
Al poco tiempo desarrolla hipoxemia e infiltrados pulmonares 🖥️
EAB: (con máscara de O2 al 50%): 7,42/50,4/36,5/-1/23/85,9% 💉
Ecocardiograma normal ❤️
AngioTC negativa para TEP ❎
Ingresa a UTI extubada, sin requerimientos de vasopresores.
Al poco tiempo desarrolla hipoxemia e infiltrados pulmonares 🖥️
EAB: (con máscara de O2 al 50%): 7,42/50,4/36,5/-1/23/85,9% 💉
Ecocardiograma normal ❤️
AngioTC negativa para TEP ❎
3/
Requiere intubación orotraqueal y conexión a asistencia respiratoria mecánica.
Cuando se procede a setear al respirador, llama la atención que la paciente tiene baja estatura (1,55 m) y sobrepeso (en la historia clínica de ingreso figura peso previo a la cirugía de 68 kg) ⚖️
Requiere intubación orotraqueal y conexión a asistencia respiratoria mecánica.
Cuando se procede a setear al respirador, llama la atención que la paciente tiene baja estatura (1,55 m) y sobrepeso (en la historia clínica de ingreso figura peso previo a la cirugía de 68 kg) ⚖️
