Week 3: Ventilation

Things to think about

• Interpretation of ABGs - beyond the basics

• Why do we ventilate? Is this different to oxygenation?

• Modes of ventilation - non-invasive and invasive

• How do we know if a mode of ventilation "works"?

• How could we set PEEP? What is the "best" way, and what is the "best" PEEP?

• Recruitment - what, why, how, and should we?

Resources

ABG interpretation:

• Acid-base disorders and osmolar gaps (LITFL)

• ABG interpretation video series (Dr Gardiner) - be warned, this is quite advanced!

Ventilation:

• Ventilation e-learning - first and second modules (e-LfH)

• Introduction to ventilators, troubleshooting the ventilator and ventilator induced lung injury lectures (Dr Howatson)

• Dr Swindin, Sampson, and Howatson's to APRV (BJAEd)

• Principles and indications for NIV lectures (Dr Bonnington, see also week 5)

• ICULearning's ventilator simulator - play with the settings without breaking a real patient

• Mechanical Ventilation Explained - a bit American, but explains the terminology

Key trials and guidelines

• · FLORALI - HFNC vs NIV for hypoxaemic ("type 1") respiratory failure

  · HIGH - HFNC vs normal oxygen in immunocompromised patients

  · ICU-ROX, Oxygen-ICU, LOCO2, IOTA, and HOT-ICU - oxygen targets in the critically ill (and a "big data" approach)

  · BTS/ICS guidelines for management of acute hypercapnic respiratory failure ("type 2")

  · PHARLAP - should we be performing recruitment manoeuvres?

  · PROBESE - is ventilation different in the obese patient?