Respiratory Therapy - Plateau Pressure and Static Compliance in Pressure Control

[@thatthiskitchen8193]

Well explained! Very useful. Thank you!

[@RespiratoryCoach]

So glad you found it useful. Thank you for watching and commenting!

[@staceyevans7602]

Useful as always!! Thank you!

[@greensahuaro2834]

You are a good teacher! Alveolar should be related to X Ray's. I think trends can help.

[@mohamedrefat7407]

Very nice, explained clearly👍

[@RespiratoryCoach]

Thank you, Mohamed. I appreciate your comment and you watching.

[@ahmedalmutairi5978]

Thank you. It’s helpful Can you talk about ‏initiate vent settings for ARDS, COPD, asthma, CF, and pulmonary edema

[@RespiratoryCoach]

Hey Ahmed, initial vent settings don't vary much amongst disease processes. Check out this video and let me know if you have any questions. kzbin.info/www/bejne/jZSuXp53q9Kmpqs

[@abeselomtedla1652]

Thanks mate 👍for the clear explanations. Calculating compliance on VCV is practical 👌perhaps i don't get how to calculate compliance on PCV ..how to calculate the driving pressure..let me know please. Regards.

[@markstoll9632]

Hi Respiratory Coach, Driving pressures are becoming important to prevent VILI. We use mainly Pressure Controlled/assist ventilation in Holland. Driving pressure is Pplat-PEEP but I was wondering: is Pplat always the same as PIP in PCV/ Pressure assist ventilation (tube compensation excluded) if not how can we use Driving pressure to prevent VILI in PCV?

[@RespiratoryCoach]

Here ya go, Mark. kzbin.info/www/bejne/on_Ne62urcepb68 Keep me updated as to how you guys are using driving pressure in PCV. I'm curious beyond my explanation in the video.

[@samanthafults9202]

Hey there! Do you have a video about what causes floppy lungs vs stiffer lungs? High vs low compliance? I already took disease and critical care classes this past semester, but I am trying to connect the dots just a tad bit better. For some reason setting up Pressure control scares me, but if I get more knowledge about the lungs actual state I might feel better about it. Thank you!

[@RespiratoryCoach]

Hi Samantha. Probably not specifically laid out to your request, but I do have videos that refer to various diseases in regards to compliance. I'll work on one for you, but it may take me a while. In the meantime, simplify like this. Emphysema = floppy lungs = increased compliance. All restrictive diseases (pna, pleural effusion, ards, pulm fibrosis, atelectasis) = stiff lungs = decreased compliance. Hope that helps for the time being, and thank you for watching!!

[@samanthafults9202]

@@RespiratoryCoach Thank you! That helps a ton!

[@hondapilot]

On the PB 980 vent in PC mode, you have a set pressure. The vent has a button to touch which performs an inspiratory hold to give you a Plateau pressure. Per your video this number would be considered invalid. Is that correct ?

[@kamaljauoda9633]

Thanks

[@RespiratoryCoach]

Your very welcome!!!! Thank you for watching.

[@andradeabisai123]

So an inspiratory hold maneuver in Volume control allows you to assess raw or better identify a problem at the tissue level vs raw. So what does an inspiratory hold on pc allow you to assess? Since Pip and pplat would be the same.

[@michaellaviola3125]

can you get a plateau pressure in PRVC since you have a targeted tidal volume?

[@nigel5009]

Hey respiratory coach, in one of your videos you stated that you can't get a plateau pressure in PCV. On a servo u with the settings PCV 10 F15 peep 8 I did an inspiratory hold and got a plateau pressure of 28 the PIP was 25. My question is, what does the 28 represent if it is not a plateau pressure?

[@RespiratoryCoach]

I should probably clarify. There is a plateau pressure in PCV, but it will be the same as your PIP by nature of the way the breath is delivered and then held. You don't see that drop from PIP to Plat like you do in VC. The reason your plateau pressure read 28, which was 3 above your PIP is most likely do to your patient actively exhaling against your insp hold. An active diaphragm can distort your pressure assessment. Does that make sense? Do you think that might have been the case?

[@nigel5009]

@@RespiratoryCoach It's possible that could have been the case.

[@CarleyKish]

Make a podcast with these videos

[@RespiratoryCoach]

That may (wink wink) be in the plans very soon! Stay tuned! Thanks for watching and commenting.

[@CarleyKish]

@@RespiratoryCoach let’s goooo!!

[@stevenr672]

On the Hamilton G5. We get a dip in pressure when in PC , doing a insp hold for a plat measurement. And the value is different than the PIP. Is it accurate ? Btw enjoy your vids!!

[@RespiratoryCoach]

Hey Steven. Thanks for commenting with this. Try to capture and send me a video of this action. I'm very curious to exactly how this works, because in theory it shouldn't. Now, is it accurate? I have no idea. Here's what I would do. Observe the plateau pressure and subsequent exhaled tidal vol in PC and then deliver that exact same tidal volume in VC and see what your plateau pressure is. If they're the same, then we'd have to call it accurate. Tell me this. Is the dip you observe always the same level of dip or does it vary per patient and per compliance, or does it always dip by 2-3 cwp? If the dip is consistently the same across multiple variables, then I'm going to guess the dip is the result of the operating system on the G5. Hope all that makes sense. Thanks again, Steven for watching and commenting!!!! Email me that video if you can. [e-mail]

[@shmuckoff]

I also have the same question. I have seen this on several ventilators as well. If the patients actual plateau is lower than the set PC would this not result in a accurate plateau when applying an inspiratory hold?

[@RedsRtrouble]

I took a practice exam this week for 2020 board exam and was blindsided by the chest X-ray pictures they asked about. Is there any easy way to know what you are looking at when it all looks like blackness and fog?

[@RespiratoryCoach]

Blackness vs fog...lol. I feel you. I remember the days when cxr seemed foreign. I'll put something together soon. Just remember that blackness = increased air (pneumothorax, emphysema), while fog or whiteness = increased density (atelectasis, pneumonia, ards, pulmonary edema). Stay tuned and thanks for watching!

[@anlu3365]

He says asthma is restrictive but isn’t it obstructive issue?

[@RespiratoryCoach]

100% Asthma is an obstructive lung disease. Sorry if I misspoke. Thanks for watching and commenting.

[@anlu3365]

@@RespiratoryCoach thank you for clarifying, I watch all your videos, they are very helpful.