The SECRET to making vent changes after a blood gas

[@allthesmallbiz9754]

Thank you for this!

[@thenicudoc]

I am so glad you like it. Is there anything you would like me to make a video of?

[@RY-zs6jx]

Thanks so much for this video Doc. You are amazing.❤

[@thenicudoc]

That really means a lot. Thank you for that wonderful comment. Best compliment is to let others know of my content so the teaching can be spread to others. Thanks again

[@neoneo-cz7zh]

Great as usual

[@thenicudoc]

You're too kind. Thank you

[@michaellaviola3125]

Hello, I had a question about blood gases on premie babies. Is it normal for gases to have so much variability, For example I've seen big changes in co2 day to day when babies have been on the same settings sometimes for the better and sometimes worse. I've also have done a CBG with a baby supine, flipped the baby prone repeated the gas in an hour with no vent changes and had the co2 improve by 15.

[@thenicudoc]

Thanks for your question. Yes, it is commonly for the gases to fluctuate, especially when they are not too old. Some of this is lung mechanics and some is the lab itself. The lung changes in its ability to blow off CO2. If the lung opens up, it can get rid of CO2 easily but if areas collapse (atelectasis) then Co2 will rise. The other way is if a baby is crying a lot when lab is been drawn, CO2 will drop. Finally, it can be lab errors. The lab was not put into the machine fast enough or there are air bubbles in the sample etc. Hope this helps

[@pppppppf]

I like it, if i may suggest something while the TikTok short format thing for each sentence may be popular here it's kinda distracting with the sound effects abrupt cuts and your fast speaking, some words tou say are even cut short by some of the effects and cuts! What are your thoughts on ultrasound for lung distension too, i noticed hypotrophic preemies especially can suprise us with lung volumes and ling distension evaluation by ultrasound helps me adjust the knobs often

[@thenicudoc]

Thank you for the kind feedback. I will continue to work on making the best content possible. Some edits are cut off out of necessity unfortunately... but appreciate your feedback. I don't really have we experience with lung ultrasound. It is used less in the US than other countries. If ot helps with making your decisions on vent changes, that's excellent. Not sure studies have shown large benefits overall for lung ultrasound but I how to learn more in the future. Thanks again for your insight.

[@pppppppf]

@@thenicudoc, OK, had no idea there's technical ramifications to these videos. They're all great information though! I check them out regularly. Agreed on the scientific evidence, i feel like some of the applications are kinda over the top (you need an ultrasound for a collapsed lung? really?) however some are very cool and i found myself using it for positional drainage guidance and lung distension evaluation often whcih i think are valuable applications that kinda fly under the radar so to say. Thanks for your work!

[@thenicudoc]

@pfirszt Yes, I am working with a couch who is teaching about editing and will continue to improve I promise. I have been to conferences where they have taught me how to use curvy B lines etc for RDS and pneumonias but I don't use it at all. I do respect those that do so. Always good to have another tool. Thanks