How to adjust Respiratory Rate (RR) according to pCO2 levels in ABG

[@drpriyanka-shelke-kolekar]

Thank you again sir for the practical learning ☺..you are making the future doctors like us Pro in critical care management.

[@clinicalworld5077]

Proud to be one of your online student ❤

[@TheICUChannel]

same here. together we are learning

[@pawankalani9454]

Good morning dear dr. Formula is new pco2=pco2×Minute ventilation ÷ New minute ventilation

[@chinmaynarayanchakrabarti9735]

The thing is , if tidal volume is fixed , the change in RR will make change in MV!! So it's same, think of it.

[@nikhilncc]

Thank you sir. I have a query. Like in the example above, if the RR is set to 14, will the PaCO2 persist to be in the 32 range? Can we also use this method in ARDS?

[@nishakushwah1422]

Thank you sir for such nice information This will be very helpful .

[@md.sultantalib4659]

Very useful video...tq again sir❤

[@TheICUChannel]

Always welcome

[@aparajitasinha6056]

Awesome video & thank you so much sir

[@dr.mahavirsinghsengar1593]

Very informative tip.

[@asmiahossen400]

Sir for other patients?? Like asthma COPD?

[@nomankhalid1496]

Sir can you please tell how to manage a patient of mysthenia crisis with type to respiratory failure On which ventilation mode we should put the patient and whether to give curare or not?

[@clinicalworld5077]

Keep shining Sir...

[@moriedahmad4514]

Thank u sir for the good topic…would u please explain how to recruit on a ventlator

[@saiyadmohammadharis288]

Thank alot sir it's very helpful

[@TheICUChannel]

Most welcome

[@jeanpomelo5884]

You are rdLly amazing!! Would like to know how to use this in kPa units, am I correct to think it will be the same formula?

[@3lo17]

Thanks , is there any role weaning. From MV by use P100 / P0.1 as parameter

[@dr.deepakgore1079]

Very nice relevant ICU post ❤❤🎉

[@TheICUChannel]

Glad it was helpful!

[@MC13133]

Is this formula only for neuro patients or not??

[@sahanaveeraraghavan6460]

Excellent tip sir.

[@TheICUChannel]

Glad u liked

[@painanddetox1394]

Can we make changes to TV or peep to achieve EtCO2. Is there any formula for that also please advise. Thanks.

[@sheikhulalam5430]

Thank you sir for great info.would please give the name of formula

[@TheICUChannel]

don't know the name, i read somewhere and use it and it works.

[@rajeshp1935]

Excellent

[@zuhairyassin505]

does apply to to stroke patients ?

[@TheICUChannel]

yes technically those who are on ventilator due to that.

[@zuhairyassin505]

@@TheICUChannel do this equation have a name ?

[@akhilraghavan1843]

What should be the I:E ratio while using this formula?

[@TheICUChannel]

All settings are kept same while using it . If you want to change them , then all will have impact

[@muzzusahmed7086]

Hello doctor thanks for the useful tip. Can I ask why is this specifically being targeted in neuro patients? Or the other way to ask why co2 wont cause vasodilation at more than 32 and vasoconstriction in less than 32 in normal patients? I'm sorry its just confusing

[@TheICUChannel]

because its what the studies have shown.

[@varunvalsalan1793]

Thanks 🤩

[@sumitkalkal7412]

Sir similarly for a patient in severe metabolic acidosis patient say pH of 6.9 After intubation We need to maintain enough minute ventilation Sir please can u explain this target minute ventilation concept I am unable to find good literature on it

[@chhunnytong2686]

thanks so much sir

[@يااللهرضاك-ف2ظ]

Thanks. Very nice

[@TheICUChannel]

welcome

[@dipankarpaul5943]

Sir one of my pt is having rt sided lrti with consolidation of the rt lower zone pt is having pco2 of 91 on admission she was intubated as she was disoriented and put on p a/c mode but despite this her pco2 just came down to 79 next day but after that rate was adjusted but despite that pco2 is not coming down then mode was changed to v a/c mode and respiratory medicine consultation was taken for changing mode of this pt they advised v a/c mode with rate of 18 but despite all her sp0 2 shows rising trend and still on abg pt pco2 never comes down below 80 and pt is not improving kindly give us ur valuable opinion

[@TheICUChannel]

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[@dipankarpaul5943]

@@TheICUChannel thank u sir please make one video on ventilator setting for treatment of CO2 retention

[@SukanyaVarun-rn5dk]

Sir Please make a video on duolevel ventilator mode🙏

[@az143ism]

what target of PCO2 is required in different diseases ? Any ref where i can look it for

[@kumaravi292006]

Sir please make a video on Pco2 level in different diseases

[@dineshrp9624]

Sir, is there a formula to reduce the tidal volume instead of respiratory rate. Does it also follow a similar formula ?

[@TheICUChannel]

I haven’t used any till now. Will check if there is any.

[@RahulSharma-nl3sj]

Hello sir According to this formula what should be ideal inspiratory to expiratory ratio? If we just set the respiratory rate but the I:E ratio is not optimum I think we will not achieve the target

[@TheICUChannel]

Tee keep usually 1:3

[@RahulSharma-nl3sj]

@@TheICUChannel thank you sir

[@THEANESTHESIST]

Can we apply the same formula in COPD pts sir for their target co2 levels ?

[@TheICUChannel]

on ventilator, keeping all settings same, if only RR have to be adjusted, than this can be applied.

[@prasoonsrivastava2909]

@@TheICUChannel sir...thank you for the video. I had a followup doubt: should we also change the Vt to maintain the minute ventilation in such cases?

[@TheICUChannel]

@prasoonsrivastava2909 not really Upto an extent because it was high MV which was causing pco2 washout

[@vijayalakshmicmsunderaj595]

Important tip.

[@TheICUChannel]

thanks

[@dr.jitendra25]

Great👍

[@TheICUChannel]

Thanks

[@anishbhattarai1297]

Dr. Ankur i have a query. I want to come and practice under you for a month or two may be. What and how can i contact you about this. Im about to join DM critical care soon so how do i contact you. Please reply me

[@TheICUChannel]

at present it's not possible but because of many requests may plan something like this in future

[@anishbhattarai1297]

@@TheICUChannel sir I'm from Nepal so may be a foreign candidate entry would be highly appreciated. It would be a great honour for me to come and learn from you. The duration of my stay will not be longer than a month or two. So Im requesting you if you could help me in this matter. All the expenses of my stay there will be self funded. I just wanna learn and help people here in my centre. If not 2 months at least a month will also be highly appreciated sir. Please can you help me.

[@TheICUChannel]

drop me an email at drankur@ esbicm.org , I will keep this in my list

[@abhishekgajera2809]

Is this apply for COPD or any respiratory disease causing increased pco2? Sir

[@TheICUChannel]

apply to anything as long as other settings remain the same.

[@akhildesu3932]

Sir, can we involve I:E ratio to this formula??? While applying this formula, we should keep same I:E ratio??just only change RR??

[@TheICUChannel]

This is when all other settings remains the same including I:E … u r just adjusting RR.

[@akhildesu3932]

Ok sir thank you

[@az143ism]

Is this formula applicable in every critical pt? Or just neurosurgery pt??

[@TheICUChannel]

Formula is applicable in every patient, pco2 target varies.

[@az143ism]

So what target of PCO2 is required in different diseases ? Any ref where i can look it for

[@sunilkumarvetty3805]

👍

[@pranavgulhane5267]

What about ie ratio in type 2 rf?

[@TheICUChannel]

kzbin.info2Tifqd8Ybmk?si=_OnslhD5mRjgsiSE

[@baijunair1720]

Sir do you conduct any critical care fellowship course??

[@TheICUChannel]

No. But CCEF does , visit collegeofcriticalcare.com

[@amberkumar3916]

Sir can we quote this Any reference to this sir

[@navneetjuneja]

Sir what is AC / VC stands for and 400 is TV ?? and also 5 / 30 %

[@TheICUChannel]

kzbin.info2Tifqd8Ybmk?si=_OnslhD5mRjgsiSE

[@denesh3s]

What will be FIO2 SIR.

[@srinivasaraosirasapalli5104]

Nice

[@TheICUChannel]

Thanks

[@ArunAnuzEditz]

❤❤❤

[@ramugoud5239]

If patient in Spontaneous?

[@TheICUChannel]

Not useful in that case obviously

[@balasundaram7781]

❤

[@KingTiger10588]

Yes more respiratory puhlez

[@TheICUChannel]

sure