NEXT :: how do I select the best PEEp during NIV? Silvia Coppola. It’s a holy grail question. But in spont breathing pts , effects on 1 effort. 2 respiratory muscles 3. Lung units. Etc #LIVES2022 #ventilation @ESICM 
High level of peep can make lung more homogeneous and reduce diaphragm stretch. pubmed.ncbi.nlm.nih.gov/27002273/ but there are 3 drawbacks 1. Neuro mechanical uncoupling
But also expiratory muscles recruitment and found increase in the activity of abdominal wall muscles and gastric pressure increases. 3. Drawback on “effort and drive”. Capturing all of this in total stress. #LIVES2022 #ventilation @ESICM
Silvia Coppola - summarises all of the PEEP questions using mechanical power paradigm. High PEEP can have benefits but detrimental. Like anything In icm , what compromise would you accept ? #Ventilation #LIVES2022 @ESICM
Luigi asking pertinent question :: “complex physiology is great but what about day to day NIV use and monitoring “? Silvia answers : P oes is the key. Without it we are in a dark in our clinical evaluation. #LIVES2022 #ventilation @katinthelair @ESICM
@katinthelair @ESICM @threadreaderapp unroll
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