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PedsCrit

PARDS--Beyond the Basics Part 3 with Dr. Nadir Yehya: Non-conventional Modes of Ventilation

Jan 16, 2023
Dr. Nadir Yehya, an expert in pediatric respiratory failure, discusses non-conventional ventilation modes like APRV and oscillation in ARDS patients. The podcast explores the advantages and considerations of these modes, as well as their effectiveness and limitations. It also delves into treatment options for pediatric patients with refractory ERDS, including the use of the oscillator and potential ECMO cannulation.
19:56

Episode guests

Podcast summary created with Snipd AI

Quick takeaways

  • Non-conventional modes of ventilation for pediatric respiratory failure include Nova, Oscillator, APRB, and high-frequency percussive ventilation, each with its own advantages and considerations.
  • APRV is effective for oxygenation rescue and lung recruitment in patients with stiff lungs, while the Oscillator provides sustained recruitment and improved oxygenation but may have hemodynamic and pulmonary challenges.

Deep dives

Modes of Ventilation for Oxygenation and Ventilation Failure

When conventional mechanical ventilation is not effectively oxygenating and ventilating a patient, several alternative ventilation modes can be considered. These include Nova, Oscillator, APRB, and high-frequency percussive ventilation. Nova is typically more suitable for non-invasive cases or weaning, while APRB prioritizes oxygenation rescue and uses periodic dumps to facilitate CO2 removal. The Oscillator excels in oxygenation and sustained recruitment but may have potential risks such as sedation requirements and poor pulmonary toilet. High-frequency percussive ventilation can address hypercarbia and secretion issues, making it effective in cases with significant secretion burdens. The choice of mode relies on the individual patient's condition and response to treatment.

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