Respiratory Therapy - Flow hunger in Pressure Control

[@tomasgarcia9726]

hey man I have to throw you some good vibes. your work is very much appreciated. keep doing what your doing because these videos are amazing and they make so much sense. Just graduated and taking my tic Wednesday. thank you and stay safe.

[@RespiratoryCoach]

Thanks, Thomas! Always appreciate good vibes. Glad you find the channel helpful. Best wishes on Wednesday. Go kill it!

[@fishingsouls4christceoofgi614]

Lol…I was thinking like the average RT, don’t touch PIP on PC. Then patient will be harder to wean… then I am connecting dots 🤪if patient is fighting the vent not in synchrony then sedating the patient is an option, that’s NOT TREATING THE PATIENT💛surely far away from weaning. Thankyou for helping us think out of the normal and helping us be the very best professionals we can be. Much love and respect. Christ be the glory

[@skyfiraprimafilla9824]

Proud of you man❤❤ I m learning lot

[@staceyevans7602]

Love it! So simple and easy to understand!

[@user-te7qf5gv8t]

Thank you !

[@tonyawindsor8679]

I am so so thankful for you! You are so easy to understand.

[@RespiratoryCoach]

You are so welcome! Thank you Tonya, for watching and commenting!!

[@ahmedistiak]

Thank you

[@FASTFitness-tf5cw]

Can you please do a video on PRVC flow hunger?

[@shiminwong2327]

it is a great explanation ! appreciate

[@mikeoldcoach4280]

I started Respiratory back in the MA1 and Bear days, we didn't have a lot of options. One trick we used was to and flow via a inline med neb with no meds.

[@RespiratoryCoach]

Wow! I admire the ingenuity of the original Respiratory Therapy pioneers. Thanks for sharing!

[@milind488]

Great explanation..

[@RespiratoryCoach]

Glad you liked it, Dr. Rawal. Thanks for your time watching and commenting.

[@kamaljauoda9633]

Thanks

[@RespiratoryCoach]

Thank you for watching and kindly commenting!

[@matty00926]

I am a vent user, not an RT, and what you are saying makes a lot of sense. Do you know why on the Trilogy in volume modes you can't manually adjust the flow? It seems to adjust it automatically according to an algorithm.

[@RespiratoryCoach]

Here you go! kzbin.info/www/bejne/g4vZhZuDjqyAepo Thanks for watching and commenting!!

[@maryamqueen5426]

Isnt the flow waveform a square in volume control?

[@alvinarauf9654]

Can we give more tidals than 6 ml/kg for fullfilling pt demand in ards.

[@latestlatest4760]

Hi..great explanation..but i need to ask you..if a patient is in ArDS and he has a high Resp rate,...i understand that increasing PIP will increase the TV too..but such increase in TV may not be appropriate for some patients because it may increase the risk of auto-peep ?..so,how can we satisfy such patient in this situation?thx

[@kylereece6761]

Can rise time help alleviate flow hunger in pressure control?

[@RespiratoryCoach]

Yes, but only if it's early insp flow hunger. Middle or late flow hunger usually manifest after the rise time is done reaching the set pressure. Just depends on when the patient is wanting the extra flow. Hope that makes sense. Best wishes, Kyle!

[@hatsonhatsoff3309]

What can we do if a vent does not have a flow rate setting? Mode is simv+vcv, i cant add a peak flow rate setting. But it does have an inspiratory time and IE setting

[@hatsonhatsoff3309]

Oh i just got it. Decrease the I time,

[@hawazen4057]

I have a Q that is bothering me for so long. I asked and searched about it but I just got more confused. Is PRVC mode pressure control or volume control ? Cuz sometimes the doctors asked to measure the plateau pressure and I don’t know if we can measure it with PRVC. As for the settings, it indicates volume control as we are setting the volume, but at the same time it has the waveform of the pressure control.

[@mugahedmugahed1879]

To obtain a plateau pressure in PRVC mode a brief transition to AC mode is required to measure plateau pressure .

[@RespiratoryCoach]

Hey Harwazen! Your very smart to note the struggles in this situation. You're right, the vents classify PRVC as a volume mode of ventilation, yet it functions as a pressure control mode. So you're right, in PRVC a mechanical breath is pressure controlled, evident by your pressure waveform. So, the answer is no. You cannot adequately assess plateau pressure while in PRVC. Not only can you not, but the ventilator cannot either. This is why the ventilator gives volume controlled test breaths after initial settings, any disconnects, or any vent settings within PRVC. Even the vent knows that a pressure control breath does not allow for adequate assessment of plateau pressure. Volume control breaths are required to properly assess plateau pressure and static compliance. Hope this answers your question. Let me know if it doesn't. Hey, thanks for watching and commenting!

[@hawazen4057]

Respiratory Coach big thanks. U explain it perfectly ❤️

[@zahraaalm8002]

Thank you. But Sr, What does it mean if there is a dip in the pressure in pressure control mode?

[@RespiratoryCoach]

Same thing. Severe flow hunger or patient asynchrony will also show a dip in your pressure waveform until the vent increases flow to correct the dip in pressure. If the vent fails to achieve the pressure set then you may have a leak in your system. Does that answer your question? Thanks for watching and commenting!

[@zahraaalm8002]

Respiratory Coach Yes, Thank you very much 🌹

[@waliddawoud9666]

U said before we can also decrease inspiratory time is that ok too?

[@RespiratoryCoach]

Hello again, honestly I would need to go back and watch the video for the full reference, but decreasing insp time in pressure control doesn't affect delivered flow. In pressure control flow and volume vary based on set insp pressure. Now, in volume control, decreasing set I time does indeed increase flow. Hope that makes sense.

[@Nolllag]

Stop treating the blood gas. Need to put this on a shirt straight up...

[@sinclair657]

Thank you