MECHANICAL VENTILATION in the SPOTLIGHT: Updates on all the latest topics
A group of top experts in the field are on hand to present and answer questions on all the latest ventilation topics during the MECHANICAL VENTILATION: HOT TOPICS 2012 session. This unmissable session will culminate in Luciano Gattinoni’s presentation “ARDS: What is the optimal respiratory monitoring strategy?”
Gattinoni will take us step by step through the basis for mechanical ventilation decision-making, starting by pointing out that the actual target of mechanical ventilation is lung protection from VILI, triggered by transpulmonary pressure (stress), and the associated strain. He will also note that the greater the lung injury severity (assessed by CT scan), the smaller the baby lung, and the greater the stress-strain induced by mechanical ventilation.
Gattinoni will also discuss the widely accepted use of the lowest tidal volume. On the contrary, he states, no survival benefits have been found when comparing lower versus higher PEEP randomly applied to unselected ARDS populations, while benefits of higher PEEP were found in the most severe ones.
“When setting mechanical ventilation: first consider the “baby lung” size. Whatever it is, always use low tidal volume, if very small (resulting in severe ARDS), use prone position and consider extra-corporeal support.” (Luciano Gattinoni)
Gattinoni will also stress other key points when determining if, how and when to utilise mechanical ventilation: The least harmful mechanical ventilation should be based on an assessment of individual patients characteristics, and seek to provide the lowest stress and strain. Associated therapies, such as prone positioning and extra-corporeal support must be sought in the most severe ARDS patients where mechanical ventilation is more harmful.
When asked to pinpoint an optimal strategy, Gattinoni says, “When setting mechanical ventilation, first consider the “baby lung” size. Whatever it is, always use low tidal volume, if very small (resulting in severe ARDS), use prone position and consider extra-corporeal support.”
Gattinoni’s talk will be followed up with an interesting discussion by Patricia Rocco entitled “Prevention is better than treatment: Changing the ARDS paradigm”.
Other featured presentations and speakers include: “Monitoring diaphragmatic function during assisted ventilation” (Antonio Pesenti); “Automatised modes. Where do they fit in?”(Laurent Brochard); “Is prone positioning evidence-based?” (Claude Guérin), and “Should we use muscle relaxants in early ARDS?” (Laurent Papazian).
17.10.2012 12:00-14:00 Berlin
MECHANICAL VENTILATION: HOT TOPICS 2012