πππ πππΎπ πππππππππ ππ
1/5
Dif Approaches to Optimizing PEEP
PEEP and RV Function
Clifford Greyson @SCCM #CCC50
#PedsICU #PedsCICU #PedsCards
1/5
Dif Approaches to Optimizing PEEP
PEEP and RV Function
Clifford Greyson @SCCM #CCC50
#PedsICU #PedsCICU #PedsCards
2/5
β«οΈFrank-Starling law is more reflective of LV physiology
β«οΈ RV normally unstressed at end diastole
β«οΈ RV maladapts to volume overload overtime
β«οΈ Distorted RV balloons impedes LV
β«οΈ RV perfusion occurs during ventricular systole
β«οΈ Vicious cycle π of RV dysfunction
β«οΈFrank-Starling law is more reflective of LV physiology
β«οΈ RV normally unstressed at end diastole
β«οΈ RV maladapts to volume overload overtime
β«οΈ Distorted RV balloons impedes LV
β«οΈ RV perfusion occurs during ventricular systole
β«οΈ Vicious cycle π of RV dysfunction
3/5
RV afterload affected by
β«οΈPVR
β«οΈPul vascular compliance
β«οΈLAP
all compromised with excessive PEEP
RV afterload affected by
β«οΈPVR
β«οΈPul vascular compliance
β«οΈLAP
all compromised with excessive PEEP
4/5
βmoderateβ PEEP can recruit alveoli, reduce hypoxia and improve Pul vasoconstriction
how CAN we tell β
β«οΈclinical improvement:
systemic pressure
β«οΈ ECHO: CO increase
βmoderateβ PEEP can recruit alveoli, reduce hypoxia and improve Pul vasoconstriction
how CAN we tell β
β«οΈclinical improvement:
systemic pressure
β«οΈ ECHO: CO increase
5/5
#COVID19 in AICU has demonstrated that the RV is a major player
figuring out what works is just not
so easy βοΈ
mortality for hospitalised patients on organ support and survival to hospital discharge ‡οΈ
sccmcovid19.org
#SCCMDiscovery
#COVID19 in AICU has demonstrated that the RV is a major player
figuring out what works is just not
so easy βοΈ
mortality for hospitalised patients on organ support and survival to hospital discharge ‡οΈ
sccmcovid19.org
#SCCMDiscovery
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