Yesterday I posted the blog "Ventilation - Playing
Defense." The blog addressed the reasons why we don't want to
intubate a patient in metabolic acidosis, the correlation between
VBG & ABG, and the importance of knowing your ETCO2 to PaCO2
gradient.
In
part two of this discussion (the podcast), Sam and I invite Bryan
Winchell on to discuss the logistics of actually setting up the
ventilator and settings that we think are helpful.
1.
Optimize volume first and then take advantage of the "no-flow" zone
to add in breaths.
2. The width of your flow waveform will tell you whether or not
more inspiratory time will = more volume.
3.These patients typically don't need a ton of PEEP because they
are spending such a short time exhaling (due to the fast rate).
PEEP of zero is probably ok because the pressure will likely never
truly get to zero. If a PEEP of zero gives you visceral pain, 3-5
mmHg is a good spot to start.