SPONT - Spontaneous Breathing = Pressure Support Ventilation ...

SPONT - Spontaneous Breathing = Pressure Support Ventilation Summary
Basic Set Parameters:
  1) Pressure Support (PS)
  2) PEEP
  3) FiO2
  4) Can adjust the trigger type and sensitivity
What's Happening:
 - The pt initiates the breath & must do some of the work of breathing (↓PS means the patient ↑work). Thus, the pt determines the rate and tidal volume.
 - Pressure support is additive to the PEEP! Ex: PS 12/6 means that in inspiration the patient receives 18 cmH2O of support. 0/6 = CPAP
Best for: For awake patients that have no significant pulm pathology
Downside: Only can be used in pts that have resp drive and participate
What's RSBI? Rapid Shallow breathing index. Marker of lung "strength" see Purple Card
Patient apneic? Most common cause is they had been hyperventilated (ASV the usual culprit). Decrease min vent & try again later
Who is ready for Extubation?
 - The reason they got intubated has improved.
 - Should be awake and mimicking commands
 - Can pull consistent Vt > 8cc/kg at 6/6.
 - Have passed a true SBT (pulling good tidal volumes @ 0/6) +/- cuff leak depending on circumstance
 - Good neck strength - a surrogate marker of diaphragm strength

Casey Albin, MD @caseyalbin

#Spontaneous #Breathing #Pressure #Support #mechanical #Ventilation #pulmonary
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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