Respiratory Therapy - Modes of Mechanical Ventilation - CPAP and Pressure Support Ventilation

[@kalelofkrypton1414]

I'm in a respiratory program and a fellow student recommended this channel, and I can definitely see why, you are great at explaining these concepts ! Thankyou sir !

[@Danogil]

Last of the One-Year Wonders, I haven't worked in Hospital in a few years (DME). Your videos help refresh my memory. Thanks

[@jillfenstermacher6179]

I am sincerely thankful for all of your videos. I really like how you make the information and concepts easy to understand. Hands down best videos for future and current Respiratory Therapists.

[@RespiratoryCoach]

I'm glad you think so Jill. Thanks for watching and supporting!

[@lionking3401]

I could never understood these before but thanks to you I can mange and help my patients better 👍👍

[@anapatriciag8510]

Buddy 👏👏you are great at making sense of RT world!

[@nardjissmaroua1480]

A very big thank you for demystifying the terminology I was struggling with Wish you all the success Carry on

[@greensahuaro2834]

Thank you! Awesome! Best wishes too! An experience I had regarding flow. I received a pt in ICU on a vent, he had a square wave flow, his HR was 133. So I read his lung Hs and he had no lung Hs. So I thought, hm!, in school I learned that a sine way is for normal lungs. I did hear his audible BS laterally. So, following what I learned, I placed him in a sine wave flow pattern. I went to chart near by, and in about 20 min his heart rate turned into NSR in the 70-80 range. Then the nurse said; and I remembered the beep sound of the alarm change, oh! He went into sinus mode! Then I went to the room and it was true. I say this cause I've been reviewing stuff in the net and I find teachers saying that square wave pattern is usually the norm on cycled ventilation. Just wanted to agree that! Thanks again and best wishes!

[@tathianeacioli2824]

Absolutely brilliant explanation of theme

[@affordofficial]

You are a great teacher.

[@lamer4550]

What is the difference between BIPAP and PSV mode? In terms of patients with tracheostomy, these two modes can apply to them. while there are differences in the specific terminology and pressure settings between the two modes, the underlying principles are similar. Both modes require patient-initiated breathing, involve the application of positive pressure to assist with inhalation, and provide a form of positive end-expiratory pressure (PEEP).

[@talaawqati7313]

Very informative lectures and you are a very gifted teacher .I am a paediatrician and been following your channel recently ,any video training regarding neonatal ventilation ?

[@RespiratoryCoach]

Hello. Not currently. I have little to no neo/pedi experience and therefore wouldn't attempt to present as an expert in that area. I've attempted to get my neo/pedi expert to join me for some videos, but haven't been able to make that happen. Hopefully soon!

[@Suzi_P]

I appreciate you so much. Always a fan

[@RespiratoryCoach]

Thank you Suzi for always watching and commenting!!!

[@pratikshasutar4328]

Conceptd getting clear thanks a loads! Could u also show these wave forms on a ventilator?

[@johnbeck9265]

Do you have or can you do a video on peep compensated and peep non compensated ventilators, and explain what you have to do to adjust when switching ventilators ? Thank you

[@ivycarter2045]

I really appreciate this learning

[@black.beauty7132]

Thank you! The content you produce is awesome!

[@smartguy5592]

Hi Thank you for this illustration I have a question: if pressure support added above the PEEP why in pressure time scaler we reached 10 instead of 15 the sum of PS and PEEP

[@RespiratoryCoach]

Great observation. I just made an error and failed to change the 10 to 15. You are correct it should've been 15.

[@gihansaleh3721]

Excellent explanation... thank you so much

[@kostasvarkoulis1678]

So cpap + pressure support = bipap. Cause on cpap with pressure support you can increase TV as well. For example if you have bipap with an Ipap = 10 Epap=5 then PS =5 and it s the same as cpap = 5 and PS of cpap = 5 . So Ipap of bipap = PIP of cpap = 10. Is this false?

[@RespiratoryCoach]

Yes, Kostas! That final sentence is TRUE!!! Strong work thinking through that!

[@skauppinen]

Huge help!

[@iftikharahmedakhundzada1369]

What are the maximum values of CPAP/PEEP, PressurtSupport, Peak,Mean and Platue pressures.

[@RespiratoryCoach]

Your max pressures are when hemodynamics become negatively effected. Watch for a decrease in blood pressure. Plateau pressures are recommended to be kept less that 28-30 cwp. Max peak insp pressure is when you notice bird beaking on your p-v loop or in PC your tidal volumes become too large. The point is, there is no single number that is the max for every patient.

[@mohamedhabibberhanu6553]

Great coach

[@dranwarali]

Thanks for explaining the concept of cpap and pressure support ventilation. can we call cpap as external PEEP. Can we apply CPAP to those who have obstructive airway disease as these patients have already increased FRC. Thanks Dr Anwar Ali from Pakistan

[@RespiratoryCoach]

Hello Dr. Ali. I'm not sure I understand the "external peep" part. May you clarify? And yes, you can use CPAP with obstructive disease. It essentially becomes mechanical application of pursed lip breathing. The CPAP in this case is not so much used to increase FRC, but more so to stent open distal airways, which will allow for more completely exhalation and reduce the risk of airtrapping/autopeep.

[@magedali4081]

@@RespiratoryCoach Is there a difference between CPAP of 5 with PS of 10 and BPAP of 15/5 !! In cardiology COP = SV ×HR Is it the same analogy in respiratory MV = TV x RR So as heart is failing it compensate by tachycardia Same wise if there is problem with minute ventilation it compensate by Tachypnea Which increases the WOB and finally Respiratory failure CPAP or EPAP reduces the elastic work to open alveoli while PS augment TV and improves minute ventilation and decreased CO2 retention I wanna hear from u if I have any erroneous concept of what I just said Thx

[@Suzi_P]

Could you please explain how to keep the Plateau pressure

[@osamamkaeeil2295]

thank you @respiratory coach i have question , correct me if i am wrong i usually work on drager EVITA XL...and as a routine , i am always activating ATC " Automatic tube compensation" while on SIMV my question is should i add pressure support level LIKE 5-8 CmH2O to overcome artificial airway resistance or ATC alone is enough ? thanks alot

[@RespiratoryCoach]

Hi Osama. You should be choosing ATC or PS. Never both. They both serve the same purpose.

[@osamamkaeeil2295]

Respiratory Coach thank you ☺️

[@TraditionswithaTwistbyDrMadhav]

Nicely explained

[@bigkeoni6429]

I'm a new user so this is all a different language to me, but my IPAP = 12.0 and my EPAP = 4.0 - Is this an OK pressure support. My diagnosis was 50 events/hr but these settings give me typically less than 3 events/hour.

[@maxpla168]

Joe, can you go into detail with IVAPS?

[@RespiratoryCoach]

Hey Max. It'll be a minute but I'll get on it as soon as I can. Essentially, IVAPS operates on a target minute ventilation, similar to ASV. This is different than AVAPS, which operates on a target tidal volume, similar to PRVC. Make sense?

[@Biomedicalcompass]

In psv why flow is not change with increase of ps, but vt changes. Flow =vt/I time, is i time increasing with increase of tidel volume in psv. Pls clarify my doubt

[@karenmitchell6654]

Thanks Respiratory Coach

[@RespiratoryCoach]

You are very welcome, Karen! Thanks for always watching and commenting!!! Been seeing your comments for a while now. I appreciate your feedback!!!

[@riffylourdesramirez5736]

May I know a ventilator that has a CPAP mode for intubated patients? And what does it settings look like?

[@RespiratoryCoach]

All vents that I'm aware of consists of a CPAP mode. All vents may not refer to it as CPAP, such as the PB 840 and 980. Their CPAP mode is labeled spontaneous, but it is CPAP often times with PS.

[@brianmulero7365]

appreciate you man!

[@ilyanoselovich2030]

How to adjust mechanical ventilation machine that does BPAP to do CPAP ? PS 10 = PEEP 10 is it correct ? Equal pressure......

[@lindabackham7937]

Do we measure pip and mean airway pressure when patients on cpap vent mode? I’ve seen therapists measured. Patients is spontaneous breathing. Let me know.

[@hoganel79]

Hi! I'm trying to understand the cycle mechanism being flow decay and not pressure in pressure support. Would the pressures delivered vary as well? If the cycle mechanism is flow decay and not pressure, is it possible that the pressures reached would vary? I hope that makes sense.

[@ReginaMarcis]

So can I say that CPAP w PS equals to BiLevel ventillation?

[@NicholasTXTV]

Thank you

[@nehalsiddiqui9689]

sir kindly explain concept of peep compensated and non compensated niv settings in c3 Hamilton

[@drmahmoudabdelhameed9345]

Thank you sir

[@tiffanidazzo9468]

Is it okay to use the mode S/T on the trilogy home vent which has a IPAP and EPAP setting on mechanically ventilated tracheostomy patients

[@RespiratoryCoach]

I'm not sure, as I'm not familiar with the Trilogy. I would reach out to the rep with specific Trilogy questions. I know you can on the V60 and old school vision.

[@tiffanidazzo9468]

Okay thank you so much

[@umasudhakar6879]

super coach thanks

[@RespiratoryCoach]

Always welcome!!! Thank you for watching and commenting!!

[@sarathajayakumar7618]

What happens when patient develop pneumothorax in CPAP/PS mode.?

[@iked2638]

Why wouldn’t you increase the I pap first for the second gas? Most doctors wouldn’t intubate with a gas like that before adjusted the bipap settimgs.

[@RespiratoryCoach]

Ike, I looked back at the video to get a frame of reference to your question, but I didn't see anything related to an ABG or bipap. Can you give me a point of reference to refer to so I can answer your question?

[@jkl1672]

When you refer to baseline are you talking about pressure?

[@RespiratoryCoach]

Yes, in this video 100%. CPAP raises baseline pressure.

[@ابوسرنجة]

Noice Keep it up

[@roshu4557]

Sir if pt is on psv mode,nd his abg is ph 7.36,pco2 of 57 hco3 38with rr of 14 fio2 -70,ps of 12 wat setting 2 change in above senario?

[@stryderhiryu8]

How much is the value of "pO2"?

[@joetraveler5609]

❤❤❤

[@maielfaki909]

Very nice

[@RespiratoryCoach]

Thanks for watching!!

[@antoniacortez4585]

Do you have any video about interpretation x-rays?