How to monitor inspiratory effort

Quantifying inspiratory effort can be useful in many aspects of assisting a person that is undergoing mechanical ventilation. For example, it represents the first step in understanding whether the level of pressure support set in the ventilator is adequate for the clinical objective or the importance of this data in the early detection of Patient Self Inflicted Lung Injury (P-SILI).

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PRONE POSITIONING: From basic concepts to practice

This article was first written during the outbreak of the SARS-CoV-2 pandemic, even though at the time the contagion is decreasing, I still think it’s very important to offer a small summary of the theory and techniques used during the process of prone positioning in patients affected with ARDS (Acute Respiratory Distress Syndrome). The prone position involves positioning the patient ventral side down and dorsal side up.

The main question is: why do we prone position patients that are affected by ARDS?

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Reverse Triggering

English version edited by Giulia Azzini, Rn, Intensive Care Unit, Department of Anaesthesiology, Emergency and Intensive Care Medicine (DAEICM), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.

In order to understand this asynchrony, it is important to know the meaning of ” Entraiment”. In physics, this term defines the phase and the timeline of a periodic external output. In a neuroscientific field, “entrainment” is when the cerebral waves show a superimposable oscillation on a periodic external stimulus. For example, exposure to music can cause a “respiratory entrainment” in the respiratory area of expertise attributed to a permanent and repetitive reaction between neural respiratory cycles distributed by the ventilator.

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Patient Self Inflicted Lung Injury (P-SILI) parte 1

japanese-ninja-concept-harakiri-260nw-1221491080Oggi propongo con molto piacere il contributo offerto a Triggerlab da un caro amico e collega, Stefano Parise, infermiere specialista clinico in medicina intensiva presso l’ente ospedaliero cantonale di Lugano (CH).

Stefano affronta un argomento molto recente e complesso, ma di grande importanza nel monitoraggio dei pazienti con ARDS: il Patient Self Inflicted Lung Injury (P-SILI).

Gli obiettivi di questo post, che ho diviso in 2 parti, sono essenzialmente due:

  1. Definire il P-SILI.
  2. Monitoraggio bedside del P-SILI. (che affronteremo nella seconda parte)

Buona lettura.

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