Clinical Challenges Session ~ How do I manage peep setting in ARDS?
HOW DO I MANAGE PEEP SETTING IN ARDS?
TABLES VS PHYSIOLOGICAL RESPONSE
How do you identify patients with higher or lower potential of recruitment?
How do you standardise mechanical ventilation in ARDS - specifically recruitment and PEEP setting?
Paolo Pelosi, (Genoa, Italy) will answer these questions in this session, chaired by Luciano Gattinoni (Milan, Italy) and offer practical suggestions for the implementation of a standardised approach to mechanical ventilation for ARDS patients at the bedside.
Optimisation of mechanical ventilation and PEEP setting in ARDS patients is essential to improve outcome. It has been shown that patients with ARDS can be separated in two main categories: 1) patients with a minimal lesion of the alveolar capillary membrane, with less oedema, less atelectasis, less potential for alveolar recruitment and less mortality; 2) patients with greater lesion of the alveolar capillary membrane, with higher oedema, higher atelectasis, higher potential for alveolar recruitment and higher mortality. It is likely that more severe patients can benefit from higher levels of PEEP during mechanical ventilation setting. During ventilation setting, three parameters should be taken into account:
1) Limit tidal stress;
2) Avoid overdistension;
3) Avoid derecruitment.
We propose a sequence of interventions to optimise and standardise PEEP setting in ARDS patients according to the most recent information from the scientific literature. These, as well as quick setting and individual setting sequences for these patients will be described in this Clinical Challenges session.
As noted, optimisation of ventilatory setting in ARDS is extremely important and a standardised approach is warranted - to learn more about how to implement one, join this informative session:
Clinical Challenges Session ~ HOW DO I MANAGE PEEP SETTING IN ARDS? TABLES VS PHYSIOLOGICAL RESPONSE
05.10.2015, 11:00 – 11:50, room Lisbon
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