Mateusz Zawadka Profile picture
Oct 23, 2022 20 tweets 7 min read Read on X
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

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More from @m_zawadka

Mar 3, 2023
Ultrasound guided subclavian/axillary vein cannulation 🧵
✅Why subclavian?
✅Why ultrasound guided?
✅How to do it?
Why axillary/ subclavian access is superior in ICU:
✅Lower risk of CVC related infections
✅Lower rate of thrombosis
✅Logistics for future lines
Why use real-time ultrasound guidance?
Summary of our recent Met-analysis with Trial Sequential Analysis
doi.org/10.1097/ccm.00…
US vs Landmark Technique
✅US better success rate and success at first attempt
✅US lower complication rate
✅US fewer attempts
✅US shorter a.time
Read 8 tweets
Oct 23, 2022
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM

SBT t-tube or PS

No one in the audience use t-tube anymore
Little support = little pregnant 😜
Respiratory load and respiratory capacity
Read 8 tweets
Oct 23, 2022
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM
The future of ARDS ventilation
What are the possibilities
Different acronym for same mode of ventilation
Can we have universal language for MV ?
Read 17 tweets
Oct 23, 2022
40 years of ECMO
What have change is understanding of MV
🫁 Focus on protection
Read 20 tweets
Oct 23, 2022
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM

Prone position
Dr Lise Piquilloud
Why we should use prone position
PROSEVA huge impact on mortality
Read 15 tweets
Oct 23, 2022
#LIVES2022 #IntensiveCare #MechanicalVentilation @ESICM

impact of MV on 🫘

Dr Antoine Schneider
Association is not causation
Read 13 tweets

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