- 112k views
Ventilatory Strategies in ARDS
Ventilatory strategies in Acute Respiratory Distress Syndrome (ARDS) are crucial for optimizing oxygenation and minimizing further lung injury. Ventilating with low tidal volumes (6 mL/kg of predicted body weight or lower) reduces the risk of ventilator-induced lung injury (VILI). PEEP is used to maintain alveolar recruitment and improve oxygenation while preventing lung collapse during expiration. A lung-protective ventilation strategy combines low tidal volume and appropriate PEEP levels to minimize barotrauma and volutrauma. Prone positioning can be beneficial in ARDS patients by improving oxygenation and reducing ventilator-induced lung injury. Allowing for higher levels of carbon dioxide (permissive hypercapnia) may be necessary to avoid excessive ventilator pressures. Continuous monitoring of oxygenation, ventilation, and lung mechanics is essential to adjust ventilatory settings as needed. Individualized PEEP selection using techniques like the recruitment-to-inflation (R/I) ratio helps tailor ventilatory support to each patient's needs.
About the Speaker
Dr. Rishabh Kumar Mittal
Principal Consultant Critical Care Medicine and Incharge Gastro Liver & Liver Transplant ICU Max Superspeciality Hospital, Delhi
Dr Rishabh Kumar Mittal is a well known intensive care physician having more than 12 years of experience in the field of Critical Care Medicine. After completing his post graduation from prestigious S.M.S Medical College and attached group hospitals , Jaipur; he ventured in the field of Critical Care Medicine and completed F.N.B in Critical Care Medicine from Fortis Escorts Heart Institute, New Delhi. He is an astute clinician and academician and is a teacher & guide for DrNB,F.N.B, IDCCM, IFCCM and IDCCN courses in Critical Care Medicine.
Upcoming Case Discussions
Clinician’s Approach to Multiple Fractures
A clinician's approach to multiple fractures involves a systematic assessment to prioritize life-threatening injuries and stabilize the patient. This typically includes evaluating the severity and location of fractures, considering any associated complications like hemorrhage or organ injury, and determining the best course for surgical or conservative management. Early intervention, pain management, and multidisciplinary coordination are key to optimizing recovery and preventing long-term disability.
Diabetes Type 2 Early Intervention
Early intervention in Type 2 diabetes focuses on lifestyle changes, such as improved diet and regular physical activity, to prevent or delay the onset of the disease. Timely management, including monitoring blood sugar levels and addressing risk factors, can significantly reduce complications and improve long-term health outcomes.
Thyroid Hormone Imbalances in Women
Thyroid hormone imbalances are common in women and can significantly impact overall health. Conditions like hypothyroidism and hyperthyroidism can cause symptoms such as fatigue, weight changes, mood swings, and menstrual irregularities. Women are especially vulnerable to thyroid issues during hormonal shifts, such as pregnancy, postpartum, and menopause. Untreated thyroid imbalances may lead to complications, including infertility, osteoporosis, or heart problems. Early diagnosis through routine blood tests and effective management with medication, diet, and lifestyle changes are essential to maintaining thyroid health.
Approach to Severe Respiratory Distress in ED
In the emergency department, the approach to severe respiratory distress begins with a rapid assessment to determine the underlying cause, including airway obstruction, pulmonary pathology, or cardiovascular issues. Immediate interventions, such as oxygen supplementation, nebulized bronchodilators, intubation, or non-invasive ventilation, are implemented based on the severity and etiology, with close monitoring for signs of deterioration.
Non Invasive Ventilation in New Borns
Non-invasive ventilation (NIV) is a vital respiratory support method for newborns with breathing difficulties. It provides assistance without the need for intubation, reducing the risks of complications such as ventilator-associated infections. Common methods include Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP). NIV is often used to treat premature infants with respiratory distress syndrome or apnea. This approach promotes better lung development and improves overall neonatal outcomes while minimizing invasiveness.