Normal HFCWO HFCWC Intrapulmonary Percussive. Case Report 7/14-8/3/2011  21 year old female admitted with acute respiratory failure requiring mechanical.

Slides:



Advertisements
Similar presentations
Non-invasive Ventilation
Advertisements

Initial Assessment of the Mechanically Ventilated Patient
The patient with shortness of breath. Differential diagnosis Asthma Asthma COPD COPD Pneumonia Pneumonia Heart failure Heart failure PE PE Other Other.
STATUS ASTHMATICUS Sigrid Hahn, MD Andy Jagoda, MD, FACEP Department of Emergency Medicine Mount Sinai School of Medicine New York, New York.
Blood Gas Sampling, Analysis, Monitoring, and Interpretation
Subcutaneous Emphysema During Laparoscopy Tiffany Thornton, MD and Quinlan Amos, MD Department of Anesthesiology, University of Arizona Health Science.
HFCWO and CF Is it Worth it?. Uses To loosen thick secretions that would otherwise remain in the lung Primarily indicated for Cystic Fibrosis patients.
Mechanical Ventilation in the Neonate RC 290 CPAP Indications: Refractory Hypoxemia –PaO2 –Many hospitals use 50% as the upper limit before changing.
Best Practices in Lung Management Experiences using MetaNeb
Sahar Elkaradawy Assistant Professor in Anaesthesia and Intensive Care Unite.
Severe Sepsis Initial recognition and resuscitation
Accelerated Ventilator Weaning Guideline A path to excellence! Click Here A path to excellence! Click Here.
Transient Tachypnea of the Newborn
1 Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 42 Postoperative Atelectasis.
Biphasic cuirass ventilation Identification BCVWhy?Who?How?Where?When?
Effect on Expiratory Flow
New Protocols for 2006 Protocols: Provide consistent predictable care for 90% of patients Development of protocols is a dynamic and ongoing process.
Mechanical Ventilation. Epidemiology 28 day international study –361 ICUs in 20 countries –All consecutive adult patients who received MV for > 12 hours.
BY: TRAVIS LENTINI Establishing the Need for Mechanical Ventilation.
Copyright 2008 Society of Critical Care Medicine Mechanical Ventilation 2.
Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Nebulized Hypertonic Saline for Bronchiolitis Florin TA, Shaw KN, Kittick M, Yakscoe.
Ventilator Modes & RN Role of Ventilator Patients in ICU
Alternatives to IPPB: a tutorial By Elizabeth Kelley Buzbee AAS, RRT-NPS, RCP.
Respiratory Failure – COPD and Asthma. 59 year old man presents to the ER with a 3 day history of progressively worsening shortness of breath. He has.
Noninvasive Oxygenation and Ventilation
Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved. Focus on Respiratory Failure (Relates to Chapter 68, “Nursing.
Building a Solid Understanding of Mechanical Ventilation
Unity Point Palliative Care Services
Arterial blood gas By Maha Subih.
Enzyme Case Studies: 1 A 67 year old male two days after sustaining multiple injuries in a motor vehicle accident complains of chest pain. There is no.
Bledsoe et al., Essentials of Paramedic Care: Division V © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Division 5 Special Considerations/ Operations.
Bledsoe et al., Paramedic Care Principles & Practice Volume 5: Special Considerations © 2006 by Pearson Education, Inc. Upper Saddle River, NJ Chapter.
RESPIRATORY SUPPORT 1.Oxygen therapy 2.Mechanical stimulator 3.Nasal CPAP / SIMV-CPAP 4.BI-PAP 5.Mechanical ventilation.
An interdisciplinary approach to care of infants with bronchopulmonary dysplasia. Alfred L. Gest, MD.
Respiratory failure 31/08/2011 Vivian Ho. Contents Definition Types Pathogenesis Effects Blood gases Management.
2012 SCONL Meeting Best Practice
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Case Study 1 A 53-year-old white male presents for annual visit. Although he quit 10 years ago he is a previous cigarette smoker with a 20 pack-year history.
Post Extubation Airway Obstruction from Occult Laryngeal Mass Post Extubation Airway Obstruction from Occult Laryngeal Mass R. Scott Childs, MD, J. Rivera-Melendez,
TEMPLATE DESIGN © Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to COPD.
Dr Kok Lai Sun Department of Medicine Hospital Pulau Pinang
Respiratory Respiratory Failure and ARDS. Normal Respirations.
Mechanical Ventilation Khaled Hadeli, M.D.. History.
Application for HFCO therapy in airway clearance.
Mechanical Ventilation 1
The Six Steps of Systematic Acid-Base Evaluation.
Is the failure of pulmonary gas exchange to maintain the normal arterial O2 and CO2 level. It is divided in to type I and II in relation to the presence.
I NDICATIONS FOR MECHANICAL VENTILATION 1.Hypoxemic respiratory failure 2. Hypercarbic respiratory failure.
Copyright © 2006 by Mosby, Inc. Slide 1 TDP REVIEW and APPLICATION.
Extracorporeal Membrane Oxygenation for Bridge to Decision and to Recovery Shigeki Tabata, Hitoshi Hirose, Nicholas C. Cavarocchi, James T. Diehl, Hiroyuki.
BTS/ICS Guidelines for the ventilatory management of acute hypercapnic respiratory failure in adults British Thoracic Society Intensive Care Society.
Respiratory Therapy. What is a Respiratory Therapist?  Healthcare professional  Diagnosis, treat, and educate patients  Work in  Hospitals  Emergency.
Cenk Kirakli, MD ; Ilknur Naz, PT, MS ; Ozlem Ediboglu, MD ; Dursun Tatar, MD ; Ahmet Budak, MD ; and Emel Tellioglu, MD A Randomized Controlled Trial.
Exam One Review N464- Fall O (2 points) Discuss why patients with pulmonary disease are prone to atrial dysrhythmias.
Principles of Mechanical Ventilation Mazen Kherallah, M.D., FCCP Internal Medicine, Critical Care Medicine, and Infectious Diseases Initial Ventilatory.
M ANAGEMENT OF ACUTE SEVERE ASTHMA Dr: MUHAMMED AL,OBAIDY CHEST PHYSCIAN MEDICAL CITY.
Copyright © 2006 by Mosby, Inc. Slide 1 Chapter 44 Postoperative Atelectasis Figure Alveoli in postoperative atelectasis. A, Total alveolar collapse.
Weaning From Mechanical Ventilation
호흡기내과 R1. 이정미. INTRODUCTION Acute respiratory failure (ARF) is the most common reason for admission in the intensive care unit (ICU), often requiring.
Inhalation injury Helena Croft JAHD 1 st May 2012.
Invasive Mechanical Ventilation
Crises in Sickle Cell Disease
EFFECTS OF INTRAPULMONARY PERCUSSIVE VENTILATION AS COMPLEMENTARY TECHNIQUE IN NONINVASIVE MECHANICAL VENTILATION DURING COPD EXACERBATIONS.
Management of Pulmonary Conditions
Session 4: Living with and managing nocturnal hypoventilation in MND
Effects of an Interprofessional Transistions of Care Clinic
Focus on Respiratory Failure
Session 3: Living with and managing nocturnal hypoventilation in MND
acute, chronic, or acute on chronic.
High flow cannula oxygen delivery and the hypoxemic patient
Presentation transcript:

Normal HFCWO HFCWC Intrapulmonary Percussive

Case Report 7/14-8/3/2011  21 year old female admitted with acute respiratory failure requiring mechanical ventilation  Received lung transplant prior year  Developed failure to thrive and acute on chronic hypercarbic respiratory failure  Past medical history of bronchopulmonary dysplasia, asthma, DVT, and immunosuppresant therapy

Case Report 7/14-8/3/2011 Prior to intubation FVC was reduced from baseline cc to 300cc. Baseline PaCO2 70 mm Hg and had risen to 124 despite optimal mechanical ventilation.

Case Report 7/14-8/3/2011 Pressure/Volume curve obtained to assess potential for lung recruitability. High recruitability Our Patient (Increased PV Hysteresis) Minimal PV Hysteresis)

Case Report 7/14-8/3/2011 Tracheal Gas Insufflation (TGI) initiated to decrease PaCO2 which had risen to >129. 7Lpm Pre TGI Post TGI pH PaCO

Case Report 7/14-8/3/2011 Heliox initiated to further facilitate improving PaCO2 and minimize AutoPEEP, however several trials failed due to hypoxia. Chest X-ray had obviously worsened.

Case Report 7/14-8/3/2011 During 2 nd day of MetaNeb in-services and we suggested the use of MetaNeb to pulmonary intensivist for secretion clearance. Although initially reluctant, MD agreed. CHFO mode was used to deliver cc of Normal Saline Q4.

CXR Improvement 7/19/2011 7/20/2011

Physician Notes 24 later

Case Report 7/14-8/3/2011 Patient survived hospital stay and was extubated several days later. Recently received her second lung transplant (for a total of 3 sets of lungs she has possessed). Patient is doing fine Even more important, the therapy left a lasting impression with the physician.

In Summary 1. RT Protocolized BHT approaches are better than Physician directed therapies. 2. Do not underestimate the benefits of optimal humidified O2 delivery & hydration 3. Conventional CPT is subpar at best. Don’t default to it because of an inability to evolve 4. Consider High Frequency devices 5. Individualize Patient Care

Feedback: Privacy Policy Feedback
Do Not Sell My Personal Information
About project: SlidePlayer Terms of Service

© 2025 SlidePlayer.com. Inc. All rights reserved.