#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
@DrLeoHeunks
ABC of weaning failure
Patient failing weaning on trachy?
Just do a bronchoscopy without positive pressure
Dexmed in failure due to agitation
Hemodynamic assessment during weaning failure?
Falling COPD pt with 3x SBT failures
sBP increases
NTG to facilitate weaning 🤯
Screen for cardiac failure even if no cardiac PMH
Measure of high MIP exclude weakness
Hand held device
Here it is again on mechanical ventilation session - ultrasound in weaning failure
@avkwong @iceman_ex
Diaphragm dysfunction first presentation of neuromuscular disorders
How to increase strength of respiratory muscles 💪?
💪💪💪
Phrenic nerve stimulation ⚡ for a win
Future of MV
⚡⚡⚡ = 💪
Muscle stronger but no impact on weaning success
Stimulation synchronise with respiratory cycle
NAWA
🫁 Improves synchronise
🫁 Shorter MV
Not often but need to keep on DDx
Conclusion
If your patient fails weaning you want to no WHY just ABCDE approach
Great talk by @DrLeoHeunks
Here the paper:
ccforum.biomedcentral.com/articles/10.11…
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