ARDS Innovation KEG

Hello,

What educational resources or training programs have you found most beneficial for improving ARDS management skills?

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[CJ] [Zenarosa] [DNP, ACNPC-AG, CCRN]
[Neurocritical Care NPP]
[WMC]
[Valhalla] [NY]
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 Look at the video Look at the videos on APRV-TCAV produced by produced by Philip Rolla  And Rory Spiegel On Vimeo.

Also review the article in Respiratory Research 2024, 25(37) by Hassan Al-Khalisy, et al

APRV-TCAV allows recruitment of atelectatic alveoli without the recruitment-derecruitment atelectatic-trauma seen in traditional modes of ventilation and allows a more gradual recruitment of lung back to FRC

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Christopher Stranathan, MD; hospitalist, St. Johnsbury, Vermont
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Original Message:
Sent: 07-02-2024 13:48
From: Bushra Mina
Subject: Best training for ARDS?

Hello,

What educational resources or training programs have you found most beneficial for improving ARDS management skills?

------------------------------
[CJ] [Zenarosa] [DNP, ACNPC-AG, CCRN]
[Neurocritical Care NPP]
[WMC]
[Valhalla] [NY]
------------------------------

Thank you Dr. Stranathan for the information. We are actually trying to set up a lecture after our first meeting with Dr. Habashi and Professor Gary Nieman to give a talk on APRV-TCAV. I truly believe in APRV if used correctly.  Stay tuned for upcoming info.

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Javier Amador-Castaneda, BHS, RRT, FCCM
Respiratory Care Practitioner
Columbia University Irving Medical Center, New York, NY
Email: ceo@iccn2023.net
Phone: 9082510631
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Original Message:
Sent: 07-03-2024 10:25
From: Christopher Stranathan
Subject: Best training for ARDS?

 Look at the video Look at the videos on APRV-TCAV produced by produced by Philip Rolla  And Rory Spiegel On Vimeo.

Also review the article in Respiratory Research 2024, 25(37) by Hassan Al-Khalisy, et al

APRV-TCAV allows recruitment of atelectatic alveoli without the recruitment-derecruitment atelectatic-trauma seen in traditional modes of ventilation and allows a more gradual recruitment of lung back to FRC

------------------------------
Christopher Stranathan, MD; hospitalist, St. Johnsbury, Vermont

Original Message:
Sent: 07-02-2024 13:48
From: Bushra Mina
Subject: Best training for ARDS?

Hello,

What educational resources or training programs have you found most beneficial for improving ARDS management skills?

------------------------------
[CJ] [Zenarosa] [DNP, ACNPC-AG, CCRN]
[Neurocritical Care NPP]
[WMC]
[Valhalla] [NY]
------------------------------

We do lots of education and lectures, both at state conferences and in the institution. I always emphasize and talk a lot on preventing ventilator induced lung injury (VILI). This the key here! Often times, people panic and crank up the settings during profound hypoxia ignoring indicators of barotrauma and volutrauma. But staying calm in the first couple of hours and keeping close eye on the airway pressures is crucial. Ventilator is a double edged sword. Hypoxia will eventually inprove in most cases as long as VILI doesn't set in. Transpulmonary pressures should be maintained within physiologic range and uniformly distributed. Minimize lung stress/strain.

Understand the physiology well since even focal ground glass opacities involving relatively small lung regions can act as "stress raisers" or "pressure multipliers" and initiate the process of VILI. 

Utilize tidal inflation patterns that employ small and slow cyclic strain rather than large and rapid deformations since this is crucial to maintaining the integrity of the pulmonary micro-architecture.

Prone early as prone position may attenuate VILI risk by increasing the homogeneity of transpulmonary pressure distribution. 

And I too am a fan of APRV. We do regular education for our staff on APRV.

Simran Kaur Matta, MD