RT Clinic: Basics of Plateau Pressure and Static Compliance, Early Indicators of ARDS
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- Опубліковано 5 сер 2024
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Early recognization of ARDS is extremely important in positive patient outcomes. Monitoring plateau pressures is a great method to trend lung compliance. This demonstration will explain plateau pressures and static compliance in terms that are easily understood by all clinicians.
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I’ve been studying mechanical ventilation for the past 8 weeks in quarantine and this video just made all of the information from the last 8 weeks make TOTAL SENSE. THANK YOU for this video 🙏 Please keep them coming!
Great videos..:) Thank you Sir..
Great explanation! Thanks!
Yeah, it makes sense that when Cstat falls below 30, it means the lung compliance is low; hence, the lungs are stiffer. Thanks.
Great vid, could you speak to ventilators that display Cstat breath to breath. Could one optimize peep levels based whether the Cstat goes up or down?
Good question! I've not used static comp to look at optimal peep, but I'm going to give it a try
Hi,thanks for this good video,can we measure the plateau pressure on pressure if we can ,i try inspiratory hold but doesn’t appear??in servo i ventilator or we can make inspiratory pause 0.5 second please answer my questions??
I've used a servo-i ventilator in the past. It was used as a transport vent, so I'm not sure if it has the advanced capabilities to read plateau pressures. I would put the scalar pressure vs time waveform on the screen, perform the insp hold, and estimate the height of the plateau based upon the y-axis.
At what point do you perform an inspiratory hold? Is it when the vent begins to deliver a breath or is a breath triggered and held when you press inspiratory hold? I'm confused. Thank you!
Thanks for the question Sandie.
It is best to wait until the patient initiates a breath. The main objective is to make sure the flow waveform has come back to baseline before doing the breath hold. This will decrease air trapping.
What happens to Pplat if you held the inspiratory hold button for longer than 3 seconds? Would that affect its accuracy?
It shouldn't affect accuracy. I've held it for 5 to 10 sec to get a stable reading because the more was a small leak.
For a highly compliant lung, what would be the Cstat value? Would it be safe to assume it's above 100, since you gave a normal range of 50-100cmH2O?
I'm not sure. Just running some numbers it takes a 1000ml tidal volume with 10 cm h2o between plat and PEEP to cause a c stat of 100. More than that is crazy.
For the tidal volume used for Cstat and Cdyn calculations, are you using the the set tidal volume in volume control or the outcome tidal volume the patient is giving? Thank you
They should be similar, but I always use exhaled Vt over inhaled Vt.
@@rtclinic Thank you
@@rtclinic Thank you
This is done if the setting is volume-controlled right? If it is in pressure-controlled ventilation no need to get the plateau pressure?
Great question. Plateau needs to be checked on both Pressure control and volume control. The inspiratory pressure on pressure control is the measured PIP. The plateau could be the same, but will likely be less than the PIP. A breath hold is used to evaluate it .
@@rtclinic Will all (ICU level) ventilators allow an inspiratory hold during PC and/or PRVC ventilation?