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Optimal PEEP studies to curb VILI / VACs

By Gregory Rittenhouse posted 11-29-2017 15:00

  
​We have started an initiative to identify patients most at risk for developing refractory hypoxemia and VILI. The following patient types are who we target:
Obesity hypoventilation syndrome
Pneumonia
Fluid overload
Bilateral atelectasis
Impending / actual ARDS
High FIO2 demand (>.5)
PEEP requirements >8cmh2O
Once we identify these patients, we perform optimal peep studies using an incremental peep titration and monitoring SpO2, BP, drive pressure
We perform these once a shift. By doing this, we are hoping to not only decrease our probability of VILI, but our incidences of VACs as well.
Is anyone out there doing anything like this?
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