Friday March 23, 2007
On reintubation rate

Here is a little twist if you are proud of your too low reintubation rate !!

"A reintubation rate of 5% to 15% is acceptable; lower rates indicate the patients are being kept on the ventilator too long, while higher rates suggest that they are being taken off too soon". - Dr. Neil R. Macintyre - at ACCP annual meeting, october 23, 2006


Related links:

HOW TO ESTABLISH A VENTILATOR WEANING PROTOCOL , Gregory P. Marelich, MD - thoracic.org

When to wean from a ventilator: An evidence-based strategy, Ref: CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 70, NUMBER 5 MAY 2003 page 389


Related previous pearls:

Spontaneous Breathing Trial (SBT) - how long - 30 minutes or 120 minutes?,
IV steroid to reduces postextubation stridor

Thursday March 8, 2007


Q: What is the basic difference between 2 major modes of 'Bilevel' ventilation - BiPhasic and APRV (Airway pressure Release Ventilation) ?


A: "BiLevel" is relatively a newer mode of ventilation which allows patient to breath normally at any level of PEEP. It is a PC (pressure control) mode of ventilation that allows both spontaneous and mandatory breaths. It has 2 levels of PEEP;

• High PEEP (PEEPH) and
• Low PEEP (PEEPL)

BiPhasic: allows patient to breath at any level of PEEP.
APRV: allows patient to breath only at high PEEP. APRV has established Time High (TH) to breath on higher PEEP and smaller Time Low (TL) to relieve pressure.

Read good description here from puritanbennett site.