Weaning APRV (P-High Setting) Using PulmoVista 500

[@vinmobile711]

Yes I have seen it. Seems a little bit too clunky. I would love to see a eit video with HFOV as well. The timpel folk have some nice ones with peds. Keep your videos up man. Good work.

[@pulmovista500guidedaprv2]

Thank you 👋 for the encouragement. I would love to expand the channel by having other clinicians discuss various topics. [e-mail] Please let me know if you ever want to join a livestream and chat. You can pass my email around if ever someone would like to present something on my channel they can.

[@pulmovista500guidedaprv2]

We don't have HFOV, but I'm working on it. I also need to convince my boss to have esophageal balloons for those rare cases (7 Liter + fluid) with obviously insanely high pleural pressures. If the EIT is saying 48 cmH20, P-HIGH is optimal, I would like that variable added to the clinical picture. Thinking a Plateau below 30 cmH20 is always safe with these patients increases mortality, but without EIT or pleural pressure, we are flying the plane blind. I had a case with a P-High of 45 cmh20 being optimal. It opened this severely collapsed lung (baby lung). Patient 7+ liters. Went to OR and eventually was 12 + liters. They called, and I said increase P-high further because volume was down to 125 ml. Instead, they were scared and lowered P-low for more of a deltaP. That increased volume for 1 hour, then lung closed never to open again. The transpulmonary pressure was not taken into consideration. The increased P-high would not have been transmitted to overdistention, in my opinion. The atelectrauma is the real killer, in my opinion. Anyways, this was a crazy case where family was pushing to continue treatment instead of letting go.

[@vinmobile711]

You have an esophageal balloon /with vids? Thanks.

[@pulmovista500guidedaprv2]

This is the only darn thing that's missing. The PulmoVista 500 has an esophageal ballon module that they are making to add to the electrical impedance tomography device. I don't know if it's on the market yet. I am working on getting this in our ICU also. Thanks for commenting 🙂