Thank you so much!! your teaching is extremely amazing and easy to follow!! best ever!
@abdigure41905 жыл бұрын
Thank you so much, I am currently taking mechanical ventilation class, these videos are extremely helpful.
@medizinundnatur14945 жыл бұрын
Many thanks for the Videos. Only a tiny little note: how quickly we need the pressure to rise is called RAMPE (for the colleagues who may see it during setting a pressure support)
@vishalgavali35443 жыл бұрын
Thank you very much for videos on mechanical ventilation. Please make video on PC mode ventilation in detail.
@andyclement40 Жыл бұрын
awesome video thanks. A pop filter might help the audio though
@ahmedalmutairi59785 жыл бұрын
PSV like BiPAP not CPAP
@joseamillategui74927 жыл бұрын
Great videos!!!they are very helpfull. One thing..isn't PEEP PLUS PS the total pressure?in the video you say PS MINUS PEEP , I think is PS (above) PEEP. Thank you very much (sorry about my english)
@pharahsaintlouis34366 жыл бұрын
Pressure support is above peep
@dr.swadeshmohanty19254 жыл бұрын
Nice explanation
@TheCriticalCarePractitioner9 жыл бұрын
Nice Ollie...we should get together soon to podcast some of this?
@RespiratoryReview9 жыл бұрын
Jonathan Downham Hey Jonathan yeah email me and we'll figure out a good time.
@Apratim983 жыл бұрын
Doc I haven't yet understood that once patient triggers his own inspiration then machine takes over quickly to reach set pressure..or it waits for patient to do max inspiration that he can and then it just provides the extra flow to reach the set pressure?
@RespiratoryReview3 жыл бұрын
The pressure support works WITH the patients inspiratory effort. It doesn't ever "take over" as long as the patient is making respiratory effort. It also doesn't wait for the end of the patient effort to "top up" the breath. PS and patient effort work simultaneously. That being said, a patient making weaker efforts will likely require more "help" from the pressure support to generate sufficient volumes, whereas a patient who is making stronger efforts will need less. It's ultimately a balance between patient effort and machine support. If the patient is not making any effort, PSV may not be the best mode for them. They may need to recover further from the underlying insult that lead them to be ventilated before PSV is tried again. Hope that helps.
@Apratim983 жыл бұрын
@@RespiratoryReview Yes now i get it fully. Thank you very much!🙏🙏
@Suzi_P6 жыл бұрын
Thank you so much
@rashadkinavakkal95293 жыл бұрын
Hi.thank you for an excellent presentation. Can we use PS as non invasive ventilation?
@RespiratoryReview3 жыл бұрын
Hi Rashad. Yes PS can be used during non-invasive ventilation. Most modern ventilators have “non invasive” modes where the patient can be receive CPAP+PS via a face mask or other NIV interface.
@rashadkinavakkal95293 жыл бұрын
@@RespiratoryReview woww,thank you for your quick response..
@rashadkinavakkal95293 жыл бұрын
Do you have any live session (certificate program)on ventilator settings?
@stomp979 жыл бұрын
Excellent. The question is really how to determine the PS value? Thank you.
@RespiratoryReview9 жыл бұрын
Great question. Setting PS is a bit of an art. You want to adjust to achieve an appropriate tidal volume, decrease work of breathing, but allow the patient to take on enough of the work of breathing to exercise their respiratory muscles. Interestingly, patients control their minute ventilation with their respiratory centre in the medulla, and increasing the pressure support (increasing the tidal volume) doesn't tend to increase the minute volume - they just breath slower to compensate. So as mentioned in the video we are less able to tightly control the blood gas in PSV. Hope that answers your question.
@stomp979 жыл бұрын
RespiratoryReview Thank you. Can one give "too much" PS, causing respiratory distress/uncomfortable sensation to the patient? I would assume so, which would tie up with your reply that this is the art of medicine.
@RespiratoryReview9 жыл бұрын
Yes definitely. Giving too much PS does a couple of things. Firstly it exposes the lungs to the well known deleterious effects of large pressure changes (deltaP as it's sometimes called), secondly it almost entirely unloads the work of breathing from the patient, which defeats the purpose of PSV. We want them to be using their respiratory muscles and contributing to the WOB. Giving too much PS is a very quick way of making someone ventilator dependant - resp. muscles atrophy and they can't tolerate not being on the vent. We've all seen that happen!
@stomp979 жыл бұрын
RespiratoryReview Great video and even better ( hardly seems possible) replies to questions. Looking forward to the next installment.
@roshu45573 жыл бұрын
Can we sedate nd paralyse pt when pt is agitated on psv mode?or srdation nd paralysis cn b done only in control mode of ventilation?
@RespiratoryReview3 жыл бұрын
Pressure support ventilation requires patient effort - which won’t happen if you paralyze them. So you can’t paralyze people for PSV. If you did, there is a built in safety mechanism of the ventilator called APNEA ventilation (or back up ventilation) which will take over and ventilate the patient. So you need a controlled mode of ventilation if you plan to use paralysis (or deep sedation - which also can lead to apnea). Hope that helps.
@roshu45574 жыл бұрын
If we set apnea time of 20 sec,then wat is role of RR,
@RespiratoryReview4 жыл бұрын
The patient decides when to breath. IF they don’t take a breath (apnea) for 20 seconds, it will trigger the ventilator to take over and deliver breaths at a preset “backup rate”. If the patient is initiating breaths there is no RR that we set. They choose how many times a minute to breathe. The back up rate only kicks in if they go apenic for 20sec (or whatever we set the apnea time threshold to).
@roshu45574 жыл бұрын
@@RespiratoryReview thanks sir
@roshu45574 жыл бұрын
Sir wat to do if rise time is oblique nt straight nd wat is its significance if it is oblique
@johntadros5016 күн бұрын
PSV is flow cycled and flow controlled not pressure controlled
@RespiratoryReview16 күн бұрын
Not sure if this is a question or not but appreciate you posting. PSV is pressure limited, flow cycled .
@johntadros5010 күн бұрын
@@RespiratoryReview Hi yes you are correct, that it is pressure-limited. I cant recall now but I believe my comment might've been a response to an error about the control variable of PSV referenced in this video, which would be flow not pressure .
@RespiratoryReview10 күн бұрын
@@johntadros50 No problem. I’d recommend you take a look at the video on phases of a breath where I cover what limit, cycle, control variables etc are. It seems like you’re confusing some of them a bit. Flow is not controlled in PSV. You’ll notice I don’t mention any variable as a controlled variable in this video.
@johntadros508 күн бұрын
@@RespiratoryReview Oh sorry you might have misunderstood what I meant by Flow -controlled. A control variable is the primary mechanism by which a breath is delivered/regulated so in the case of PSV that would be flow. A common mistake people make when thinking of PSV is that pressurized air is being delivered but this is not the case. Flow is delivered and that flow creates a pressure which we limit with the pressure support parameter.
@RespiratoryReview8 күн бұрын
@@johntadros50 Sorry John you're mistaken here. Flow is variable in PSV. It isn't controlled by the ventilator. Look up Pilbeam, S.P. (2015). Mechanical Ventilation: Physiological and Clinical Applications. Elsevier Health Sciences