4 ms·
Actually exhalation is passive, not active, in modern day ICU ventilation.
by bearsnowstorm 7y ago
Actually exhalation is passive, not active, in modern day ICU ventilation.
- elric 7y agoInteresting. How does that work? Does the pressure drop to let air out or something?
- haldujai 7y agoTo keep it simple you have a device that increases pressure through a closed circuit to push air into the lungs, when its time to exhale it drops pressure (although is still positive pressure i.e PEEP) that is weaker than the natural recoil/elasticity of the chest wall combined with gravity in a supine patient and allows exhalation.
- bearsnowstorm 7y agoAgree. I'd add that my comment above about exhalation being passive is true in adult ICU practice. In high frequency oscillatory ventilation (HFOV) exhalation is active (a piston actively creates a negative pressure in the breathing circuit). I understand this is still used quite a bit in neonates (though I don't do NICU, so not an expert) but has gone out of favour in adults in a big way due to the results of trials like OSCILLATE (https://www.nejm.org/doi/full/10.1056/NEJMoa1215554 https://www.nejm.org/doi/full/10.1056/NEJMoa1215554). Probably still used in some centres as a rescue therapy, but I haven't used it in years (we'd use VV ECMO for that purpose).
- burfog 7y agoThis infuriates me. It's cutting corners, reducing the quality of care. There are now portable iron lungs that fit like a turtle shell. They do both inhalation and exhalation. That should be the only acceptable standard of care.