Advanced Vent Modes - PRVC, APRV, HFOV and MORE!

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ICU Advantage

ICU Advantage

Күн бұрын

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In this lesson we advance our discussion talking about ventilators as we talk about some of the more advanced vent modes that we have out there. This lesson is meant as a quick overview of these different modes, as future lessons specifically looking at each of these individually will have much more information.
We start off circling back to our understanding of volume control versus pressure control. I talk about the compliance equation and how each of our variables, volume and pressure play in to this equation. Understanding this equation and the difference between these types of ventilation is key really understanding these advanced vent modes.
From there I talk a little about Pressure Regulated Volume Control (PRVC) and how this dual mode ventilation actually works. Next I move on to talk about Airway Pressure Release Ventilation (APRV) a very common and effective mode of ventilation for alveoli recruitment and improved gas exchange. Finally I talk about High Frequency Oscillatory Ventilation (HFOV) or the oscillator. While very common in the NICU with babies, this is still something that we can see used in our adult patients.
Hopefully by the end of this lesson you will have a basic understanding of these various types of advanced vent modes, how they are different from one another, and how it is that they achieve their benefit with our patients.
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A big thank you to ‪@RespiratoryCoach‬ for helping to review over the information for this lesson. He has an awesome channel with great info related to respiratory care, so make sure and head over and check him out!
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#ICUAdvantage #Advanced #VentModes

Пікірлер: 110
@ICUAdvantage
@ICUAdvantage Жыл бұрын
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@RespiratoryCoach
@RespiratoryCoach 4 жыл бұрын
Sharing this resource with all of my students! Great, simple break down of these "advanced" modes of mechanical ventilation. Strong work, Eddie! Appreciate the shout out.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Awesome! Glad you liked how it came out and hope your students find it useful!
@khadijabelqas
@khadijabelqas 2 жыл бұрын
Thank you!
@ericbalti
@ericbalti Жыл бұрын
​@@ICUAdvantage lol my kn😊
@moritzwolle2141
@moritzwolle2141 2 жыл бұрын
Hello, learned a lot while working on covid icu. It really helped to daily see different stages for ARDS for months... :)
@hannahthompson93
@hannahthompson93 3 жыл бұрын
Thank you for these! I'm a couple weeks into orientation in the CVICU. I have been totally unable to grasp the concepts behind the various modes of mechanical ventilation despite other nurses' attempts to explain it to me. These videos have literally saved me. It's so understandable if explained well. Now I'm going to go watch your drip videos...
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
So awesome to hear this Hannah! So glad that this video was what you needed! Congrats on the new position. Lots of good videos here I think you'll like. Welcome to the channel and best wishes on your new nursing adventure! 😊
@wa590
@wa590 3 жыл бұрын
Thank you!!! You helped break it down in simple terms, something I haven’t been able to get from anyone yet (including my professors). Thank you!!!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Wow, really awesome to read this! Thanks for the comment!
@user-ik2yy1qn9g
@user-ik2yy1qn9g 4 ай бұрын
JUST WANT TO SAY THANK YOU FOR THESE VIDEOS AND THE GOOD INFORMATION YOU HAVE PROVIDED I AM THINKING OF GETTING INTO RESPITORY THERAPY AND THESE VIDEOS ARE GREAT INFORMATION TO BE ABLE TO WATCH AND GET EDUCATED. I HAVE WATCHED LIKE 7/8 VIDEOS JUST FOR THE GREAT INFORMATION THAT YOU PROVIDE
@conniera
@conniera 4 жыл бұрын
I'm an RT student and that was an excellent to the point explanation of those modes. Subscribed. Thank you!
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Awesome Connie! Glad to have you on board and glad you liked the video!
@nicklind39
@nicklind39 2 жыл бұрын
Incredibly helpful. Thank you so much. All your content is great.
@Lishaaaaaaa
@Lishaaaaaaa Жыл бұрын
Oh, you absolute star. This is excellent revision material, especially for someone like me who's a bit poorly atm, so information retention is a struggle.
@veerchasm1
@veerchasm1 3 жыл бұрын
I’ve been an RT for 29 years, great explanations
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Awesome to hear this! Thank you and glad you liked it! :)
@TudyaliweChakwiya
@TudyaliweChakwiya 3 ай бұрын
@
@kyleessex6301
@kyleessex6301 Жыл бұрын
I love our videos, I do. I do need to mention for many who may be watching this that it is an important distinction regarding compliance as the the ability to expand and that the force acting to contract is elastance. This is a concept that I have even seen many Physiology PhD's mix up. So compliance force to expand, and it acts in opposition (Inverse relationship) to elastance or recoil. This plays a factor in ventilation, perhaps most easily explained with COPD patients. Barrel chesting is associated with an increased compliance with the associated decrease in elastance.
@carleighmiller542
@carleighmiller542 4 жыл бұрын
I FINALLY UNDERSTAND. Thank you so much. You made learning this actually entertaining!
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
YES!!! So awesome to hear this!
@christinemjs
@christinemjs 4 жыл бұрын
I have just started in ICU and I am finding all of your videos very very helpful!! Thank you!
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
This is so awesome Christine! Welcome to the amazing world of critical care! Its such a fun journey of life-long learning and truly caring for people at deaths door and actually playing a part in saving peoples lives. Its such a fulfilling career and I wish you the best. So glad to hear that you find these videos useful!
@nan_c77
@nan_c77 3 жыл бұрын
Thank you for the Ventilators videos! What a great way to review!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Awesome to hear this! You are very welcome!
@dawnbundy4308
@dawnbundy4308 3 жыл бұрын
Thank you for the break down and ever so patient explanation!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Really happy to hear this! You're welcome!
@MrKir03
@MrKir03 2 жыл бұрын
You sir are God sent. Extremely helpful for my ICU rotation
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Truly happy to be able to help!
@karawelch1123
@karawelch1123 4 жыл бұрын
Thank you for your AWESOME videos!!! I am and RN starting in ICU this month and am very excited; your videos are easing my nerves. I have a suggestion for a video to make: transvenous pacing. Thank you :)
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
How exciting Kara!! Its one heck of a journey but working in the ICU is truly unlike anything else. I wouldn't trade it for the world. I'm so glad you like the videos and I really appreciate you taking the time to leave such a great comment! 🙂 Also thank you for the suggestion. I actually have temp pacing stuff coming up on the to-do list relatively soon, so keep an eye out for those videos when they come out!
@arshadhussain8797
@arshadhussain8797 3 жыл бұрын
Kindly make more videos on ventilators like more advanced modes, ventilator graphics and protocols followed in ICU...these videos are really helpful ! Thanks👍
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Really glad to hear you liked it Arshad!
@arseniohardrick3123
@arseniohardrick3123 2 жыл бұрын
Thank you Eddie, please keep pumping out the content.
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Will do! Glad you liked it!
@maddiegirlx4
@maddiegirlx4 4 жыл бұрын
Thank you so much! I am brand new nurse starting on an ICU floor!
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
So exciting! Congrats on the new position and really glad that you enjoyed the video!
@D1G1TALSYNAPS3
@D1G1TALSYNAPS3 3 жыл бұрын
This is good supplemental education but please talk with your RTs to get more info.
@Reyalegro
@Reyalegro 2 жыл бұрын
Thanks, these videos are really helping me study for my FCCS course!
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Awesome! Glad you are finding them helpful!
@elevatenursing
@elevatenursing 2 жыл бұрын
This is pretty useful! I will be referring to these notes in future and to my students too. Thanks!
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Awesome! Glad you liked it and thanks for spreading the word!
@mohamedhabibberhanu6553
@mohamedhabibberhanu6553 2 жыл бұрын
Thank you sooooo much , your channel is so powerful and very educational. I really enjoyed when I listened to it
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Wow, thank you so much! Really happy to hear this.
@gingingsisangag
@gingingsisangag Жыл бұрын
Hi! Thank you for this Eddie. Could you pls add a video regarding mech vent alarms
@akashmaheshwari2016
@akashmaheshwari2016 2 жыл бұрын
Nice work...the way you have explained the entire ventilator series is amazing 🙌🙌 I have only one Doubt!!.. The PRVC should be volume control as we set the target volume which is needed to be achieved by the the ventilator by adjusting the pressure? You have mentioned it as pressure control@ 10:08
@gideonecube7552
@gideonecube7552 4 жыл бұрын
Many thanks for the lectures. I appreciate your work 😊
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
You’re very welcome Gideon and thanks so much for taking the time to leave a comment!
@TamNguyen-lu9fd
@TamNguyen-lu9fd Ай бұрын
Many thanks, you’re so great.
@21klauss
@21klauss 4 жыл бұрын
Thank you 😊 I totally understand PRVC now
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
You're welcome 😊 Glad this video helped!
@TS-pq1iy
@TS-pq1iy 4 жыл бұрын
Thanks for these videos! So helpful.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Awesome! So glad you like them!
@BIGBADRAEVEN
@BIGBADRAEVEN 4 жыл бұрын
SUBSCRIBING ! I just got out of school ,and I could never understand pressure control; now I do‼️
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
So awesome! This is great to hear. Thank you!
@lonestarbulls9001
@lonestarbulls9001 2 жыл бұрын
amazing video! will you be posting more in-depth videos on the individual advanced vent mode settings? Thank you for making these!
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Glad you liked it. And yeah probably in the future, but not sure when
@ohappye745
@ohappye745 4 жыл бұрын
Thank you, your video is really useful for me.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Glad it was helpful!
@ruthtarasko3849
@ruthtarasko3849 3 жыл бұрын
Eddie! New subscriber here and loving your content! I’m wondering if you don’t already have one on how to understand CXR. We take them daily in our ICU and I’m embarrassed to admit I have no idea what I’m looking for when I look at them with the team.
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Yay welcome aboard Ruth! Happy to have you here! Don't be embarrassed. If no one every showed you anything, its hard to know what to look for and they don't really cover this at all in school, but is very important, especially working in the ICU. I don't have a lesson on this one yet, but it def is on the todo list to get to!
@authman-alshibly
@authman-alshibly 2 жыл бұрын
How far is the 'test volume' that the ventilator uses in PRVC from the 'targeted volume' usually? What does the ventilator do if the lungs' compliance does not match the 'targeted volume'?
@Apratim98
@Apratim98 3 жыл бұрын
Thank you so much for this great video!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
You're very welcome!
@greensahuaro2834
@greensahuaro2834 Жыл бұрын
your teaching is awesome!!!!! you go to the point!
@ICUAdvantage
@ICUAdvantage Жыл бұрын
Thank you so much. I try, but sometimes feel like I drone on, and other times like I don't cover enough haha
@greensahuaro2834
@greensahuaro2834 Жыл бұрын
I think you'll make a GREAT UNIVERSITY PROFESSOR.
@alissoncarmiol
@alissoncarmiol 4 жыл бұрын
Amazig explanation thank you so much.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
You're very welcome Alisson!
@danronck3636
@danronck3636 4 жыл бұрын
Thank you for this amazing Video, I'm a 3rd year Med student and i would have a Video suggestion: what skills would you and other RN value in young students coming to ICU for their internship? I love working with RN and would love to be able to give you guys as much support as possible. Thank you
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
You're very welcome. Honestly, as an intern being around experienced critical care nurses, the best skill you can bring is being willing to listen to the bedside RN. Especially the experienced ones, as you will be surprised how much you can learn. The best attendings learn to lean heavily on the thoughts and suggestions of the bedside RN as they are there for so much more time and see many little things that can easily be overlooked.
@danronck3636
@danronck3636 4 жыл бұрын
@@ICUAdvantage I've already come to that point, I did some voluntary internships and I noticed right from the start how precious our RN are. I love them and treat them like gold, bring chocolates or breakfast to the shifts. I just love my ICU RN. But fair point, I do agree that too many MedStudents underestimate the RN. But honestly, no MedStudent could ever reach the depth of knowledge of the RN. Thank you to all you amazing RN out there🙏🙏🙏
@raman6972
@raman6972 3 жыл бұрын
Thank you...really helpful. Can you explain how we choose the mode of vent for our patients i.e vol or press control or pvrc. i.e patient with chest inury, type 2 resp failure (COPD), severe asthma, CAP etc etc I was taught traditionally to avoid vol control in airway obstructive diseases...is that still true?
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Great question. So, much of it depends on 1) patient tolerance and 2) goals of care. Remember between volume and pressure we are in control of just one of the variables. The other happens as a result, instead of just setting it. In obstructive disease there may be benefit in regulating pressure to achieve volumes, but its almost never and always and/or answer. Honestly a quite complex answer to deciding when to use what, and certainly some providers have preferences to use one over the other more often.
@alexwoelfel8934
@alexwoelfel8934 10 ай бұрын
Can you explain the Weening process for pressure control and why pressure control is the mode used for this? I am confused why we wouldnt just use something like PRVC? Pressure control seems like it gives less control to the patient as their is still inspiratory pressure and a frequency and time, where PRVC just adjusts it to what is needed or if the patient is getting better.
@ICUAdvantage
@ICUAdvantage 10 ай бұрын
I think you may be confusing pressure control and pressure support. Typically pressure support is whats used for weaning trial. No delivered breaths with just PS and PEEP to assist the patient, although for weaning generally at low levels. If they do well, its a good indicator they would do well breathing on their own without the tube.
@Medicinalmagic911
@Medicinalmagic911 2 жыл бұрын
17year medic. This is incredible. Thank you
@ICUAdvantage
@ICUAdvantage 2 жыл бұрын
Awesome! Glad you liked it!
@mhossain333
@mhossain333 4 жыл бұрын
Nicely explained
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Thank you Mahtab!
@samuelhumphrey2823
@samuelhumphrey2823 3 жыл бұрын
Thank you im a new ICU nurse
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Awesome! Welcome to the world of critical care Samuel!
@laurenguhr2856
@laurenguhr2856 11 ай бұрын
We use BiLevel alot - sounds similar to APRV
@mundymorningreport3137
@mundymorningreport3137 4 жыл бұрын
Hey, I really appreciate the video explaining the mechanics and clarifying the limitations of this essential function of life and healing. So, why not bypass the limitations entirely with HBO2? Seriously, can any ICU be complete without it? Anything that you can bring forward on this therapy would be appreciated. Thanks so much. Why isn't it more popular? B
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
HB02? Do you mean HFO2?
@greensahuaro2834
@greensahuaro2834 3 жыл бұрын
Many thanks!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
You are very welcome Carlos!
@user-jk1jw3rf8v
@user-jk1jw3rf8v Жыл бұрын
Can you pls do a video on interprwting VENTILATOR GRAPHICS
@iia61
@iia61 3 жыл бұрын
Thank You!!!
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
You're welcome Iva! 😊
@spicefaith7419
@spicefaith7419 3 жыл бұрын
Thank you so much
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
You're most welcome
@ahmedelkomy6309
@ahmedelkomy6309 4 жыл бұрын
awsome. please, could you tell me about the software you are using in explanation?
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Adobe Photoshop. Then use Astropad Studio to put my Mac screen on my iPad to write with the pencil.
@moila04
@moila04 3 жыл бұрын
Thanks again for the video ☺️.I have a question about the difference between VC and PRVC. With VC, the set tidal volume is always delivered. What happens if the lung compliance is really bad, can the vent still always deliver the set tidal volume? And in PRVC, there is a ‘target tidal volume’. So is the main difference between VC and PRVC, is that in VC, the tidal volume is always the same no matter what the lung compliance is but in PRVC the tidal volume changes breath by breath?. Is it possible I’m that the target tidal volume is never achieved in PRVC?
@shawnjade7005
@shawnjade7005 2 жыл бұрын
To answer your first question about VC, yes it will deliver the set volume despite having a bad compliance. The pressure will be high and may cause volutrauma.
@safaasaud
@safaasaud 4 жыл бұрын
Please do videos about ICU bundles, also most common procedures.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Thanks Safaa! Any particular procedures you have in mind?
@safaasaud
@safaasaud 4 жыл бұрын
ICU Advantage ECMO, Central Line, Arterial Line, Chest tube, Intubation/Extubation.
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
@@safaasaud Just about all of those are on the to-do list, except a-lines and extubation. Adding those now!
@robertbrindus6597
@robertbrindus6597 4 жыл бұрын
Your videos are a great help in general, and that's why I say thank you. But in this particular case, I can't understand from your explanation the differences between classic VC and PRVC. You say that in PRVC we set a 'target volume' and the ventilator it's constantly adjusing the Pinsp based on the compliance, to achieve that 'target' set. But the same it's in standard VCV, as the constant 'Tidal Volume' that we set is achieved by automatically regulating Pinsp. Sorry, but from your video I could not understand why PRVC is an "advanced mode", as there seems to be no difference to standard Volume Controlled Ventilation
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Sorry that it wasn't clear. PRVC and VC are quite similar, but VC you have a SET Vt and each breath will be approximately at that set volume, assuming no pressure limits are hit. PRVC adjust the pressure used to deliver the breath slowly over several breaths. You set a GOAL Vt but as compliance changes volumes will change with breaths until the ideal pressure is achieved. PRVC gives a lot of the protective benefit of pressure control, while still working to achieve a goal tidal volume. Its a smart mode, much smarter than VC or PC, and hence why it ended up in the advanced modes lesson. A lot of places don't have this mode available or hardly ever use it. Hope that makes sense.
@robertbrindus6597
@robertbrindus6597 4 жыл бұрын
@@ICUAdvantage It makes more sense now, indeed. I'm an ICU resident doctor in Romania using a General Electric anaesthesia machine (started with my anesthesiology rotation) and I could not find this mode on my software. The most advanced are SIMV + BV (backup volume) and PSV-Pro (pressure support).
@renandclervoyant5524
@renandclervoyant5524 Жыл бұрын
Bilevel is the same as aprv
@llanceend2970
@llanceend2970 3 жыл бұрын
Hey buddy many thanks for super content as always ..only that sometimes if you can please don't rush the topic particularly as these are complex topics ..here I feel you overtly rushed ..otherwise you just dumping critical knowledge and not allowing people to take the tips in. Cheers
@ICUAdvantage
@ICUAdvantage 3 жыл бұрын
Hey thank you so much for the feedback. Its tough because I have some people who say I drag on too much and others who say I go to quick. I try to find a good balance with it but it certainly is a work in progress. If there ever is a part that you need further clarification on, let me know and I can try to explain more, or perhaps it might make for a good individual lesson later on. Appreciate you and your support!
@freecopt4003
@freecopt4003 4 жыл бұрын
why do not you call it vol control ? because the set is targeted vol not pressure and pressure is variable
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
? What are you referring to?
@freecopt4003
@freecopt4003 4 жыл бұрын
@@ICUAdvantage Dual mode pressure regulated vol control ventilation
@ICUAdvantage
@ICUAdvantage 4 жыл бұрын
Oh got ya. Well essentially you aren't setting a set volume, but a volume target. Therefore the volume given may not always be what you are looking for, based on the pressure regulation. I think we could probably say its a primarily volume focused mode, but not truly a volume control. But really, its just semantics at this point too :)
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