![]() This increases CO2 and lactate production, both of which may be problems of their own. In intubated patients with low compliance, work of breathing can represent an important part of their total energy expenditure (up to 30%). This is especially important for stiff lungs with low compliance. If a patient needs to clear CO2 by improving ventilation, he should receive some level of pressure support for his ventilation, either via BPAP or invasive ventilation.Įxtrinsic PEEP also significantly decreases the work of breathing. Nevertheless, extrinsic PEEP should never be used for the sole purpose of increasing ventilation. By opening up airways, the alveolar surface increases, creating more areas for gas exchange and somewhat improving ventilation. The application of extrinsic PEEP will, therefore, have a direct impact on oxygenation and an indirect impact on ventilation. The application of positive pressure inside the airways can open or “splint” airways that may otherwise be collapsed, decreasing atelectasis, improving alveolar ventilation, and, in turn, decreasing VQ mismatch. This, in turn, increases the solubility of oxygen and its ability to cross the alveolocapillary membrane and increase the oxygen content in the blood.Įxtrinsic PEEP also can be used to improve ventilation-perfusion (VQ) mismatches. This applies to mechanical or noninvasive ventilation in that increasing PEEP will increase the pressure in the system. By Henry’s law, the solubility of a gas in a liquid is directly proportional to the pressure of that gas above the surface of the solution. His one great achievement is being the father of three amazing children.Extrinsic PEEP can be used to increase oxygenation. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of , the RAGE podcast, the Resuscitology course, and the SMACC conference. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. ![]() He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. ![]() He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.Īfter finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |