This is written with a busy, fatigued resident in mind. Ventilator associated lung injury barotrauma volutrauma biotrauma recruitment. The barotrauma vs volutrauma debate continues, but the volutrauma camp seems to have gotten. Lungprotective ventilation asv employs lungprotective strategies to minimize complications from autopeep and volutrauma barotrauma.
Neuromuscular blocking agents in ards critical care canada. Optionally, if you want to change what the final pdf file is like, do any of the following. Alveolar overdistension volutrauma atelectrauma biotrauma inflammation clinical. The goal is to facilitate learning of critical care medicine. This is a pdf file of an unedited manuscript that has been accepted for. Comparative effects of volutrauma and atelectrauma on lung inflammation in experimental acute respiratory distress syndrome. Opening the lung with peep and increased mean airway pressure is the best way to help this. Pdf converter is a online webbased document to pdf converter software. Neonatal chronic lung disease sydney local health district. Marini2, francesca collino1, giorgia maiolo1, francesca rapetti1, tommaso tonetti1, francesco vasques1 and michael quintel1 abstract the adverse effects of mechanical ventilation in acute respiratory distress syndrome ards arise from two main. Preschool ptsd treatment ppt is a theorydriven, manualized protocol based on cognitivebehavioral therapy cbt with modifications for young children. Current thinking regarding ventilatorinduced lung injury includes barotrauma, but the real emphasis has shifted to volutrauma.
This is not a forum for general discussion of the articles subject. Injury to aircontaining structures, such as the middle ears, sinuses, lungs. The childs lungs also require earlier ventilatory support to avoid the pulmonary collapse that threatens as soon as the child goes into hypoventilation. Save powerpoint presentations as pdf files office support. A free powerpoint ppt presentation displayed as a flash slide show on id. The three most important advances in prevention and treatment of rds have been. Minimize lung injury secondary due to volutrauma and oxygen toxicity.
Risk of volutrauma other means to decrease p aco 2 reduce muscular activityseizures minimizing exogenous carb load controlling hypermetabolic states permissive hypercapnea preferable to dangerously high rr and t v, as long as ph 7. Chorioamnionitis and an inflammatory cascade have also been implicated in the pathogenesis of cld. Neonatal tidal volume targeted ventilation colin morley retired professor of neonatal medicine, royal womens hospital, melbourne, australia. Select minimum size to make the file smaller for example, if you want to send it as an email attachment click options to set how the presentation will appear as a pdf. Rds, also known as hyaline membrane disease, is the commonest respiratory disorder in preterm infants.
Ventilatorassociated lung injury vali is an acute lung injury that develops during mechanical. In light of all the above, it could be said that noninvasive mechanical ventilation seems to. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Chronic lung disease bronchopulmonary dysplasia was first described in 1967 as severe chronic lung disease cld in preterm infants with severe respiratory distress syndrome rds who received treatment with 100% o2, high inspiratory ventilator pressures and no peep. Zone 3 demonstrates shunting perfusion without ventilation. The clinical diagnosis is made in preterm infants with respiratory difficulty that includes tachypnea, retractions, grunting respirations, nasal flaring and need for fio2. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. Airway pressures and volutrauma ventilation, and permissive hypercarbia. The manual was created for use in a trial for 36 yearold children. Lung injury can be initiated at birth with the delivery room resuscitation. It also prevents apnea, tachypnea, dead space ventilation, and excessively large breaths. Neonatal chronic lung disease introduction chronic lung disease cld results from the effects of positive pressure ventilation on a structurally and functionally immature lung. Convert and create pdf from various types of files like word doc, excel xls, powerpoint ppt.
The content on the uptodate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. The palicc recommendations provide guidance on conventional ventilator management, gas exchange goals, use of highfrequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for. Zone 1 demonstrates deadspace ventilation ventilation without perfusion. Topic summary 12 page handout summary of the topic. Adequate tidal volume must be achieved gradually and adjusted with each subsequent breath to achieve adequate, but not excessive, tidal volume delivery.
Meade, md, frcpc critical care consultant, hamilton health sciences professor of medicine, mcmaster university. Online icu manual the target audience for this online manual is the resident trainees at boston medical center. Lung protective decreased risk for barotrauma and volutrauma less sedation is needed and patient is more comfortable assess proper peep levels diaphragm atrophydysfunction is reduced better able to assess patients wob post extubation. Acvg or high frequency ventilation or changing peep. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Some of these modifications involve parentchild relationship dynamics that are salient for this age group.1104 209 213 997 741 149 210 671 1064 1348 322 1112 869 750 930 1373 1117 166 1334 86 177 1189 1259 1473 1343 302 1318 1276 1184 162 661 1066 1285 1177 1467 182 932 1494 343 1468 76 679 1132 1462 858 1336 1225