High frequency ventilation ppt dr vinit patelVINIT PATEL
HIGH FREQUENCY VENTILATOR FOR NEONATES
NEONATAL VENTILATOR
PPHN,MECHANICAL VENTILATION,ADVANCE VENTILATION,NITRIC OXIDE,SLE 5000,SENSOR MEDICS
DR VINIT PATEL
High frequency ventilation ppt dr vinit patelVINIT PATEL
HIGH FREQUENCY VENTILATOR FOR NEONATES
NEONATAL VENTILATOR
PPHN,MECHANICAL VENTILATION,ADVANCE VENTILATION,NITRIC OXIDE,SLE 5000,SENSOR MEDICS
DR VINIT PATEL
High-frequency oscillatory ventilation (HFOV) is an advanced mechanical ventilation strategy utilized in the management of respiratory failure, particularly in critically ill patients. It employs small tidal volumes delivered at rapid rates to maintain lung recruitment and gas exchange while minimizing the risk of ventilator-induced lung injury (VILI). HFOV is commonly employed in neonates, infants, and adults with acute respiratory distress syndrome (ARDS) or other conditions characterized by severe respiratory compromise.
The fundamental principle of HFOV involves the delivery of very small tidal volumes (often in the range of 1-3 mL/kg) at high frequencies (typically between 3 and 15 Hz). This approach differs from conventional mechanical ventilation, where larger tidal volumes are delivered at slower rates. The goal of HFOV is to provide adequate ventilation and oxygenation while minimizing the risk of lung injury associated with high tidal volumes and pressures.
In HFOV, gas is delivered into the airways in the form of rapid oscillations, creating small pressure changes that promote lung recruitment and gas exchange. These oscillations are superimposed on a baseline level of continuous positive airway pressure (CPAP), which helps to maintain lung volume and prevent atelectasis during expiration. The combination of high-frequency oscillations and continuous positive pressure facilitates gas exchange by improving alveolar ventilation and reducing intrapulmonary shunting.
The oscillations in HFOV are typically generated by a piston or a diaphragm within the ventilator circuit. The rapid oscillatory motion of the ventilator creates pressure fluctuations that are transmitted to the airways, causing the lungs to expand and contract at high frequencies. This cyclical stretching and relaxation of the lung tissue help to open collapsed alveoli, redistribute lung volume, and improve overall lung compliance.
One of the key advantages of HFOV is its ability to deliver ventilation while minimizing the risk of VILI. By using very small tidal volumes and high frequencies, HFOV reduces the mechanical forces applied to the lungs, thereby decreasing the likelihood of barotrauma (pressure-related lung injury) and volutrauma (overdistension of the alveoli). This makes HFOV particularly suitable for patients with ARDS or other conditions where lung injury may be exacerbated by conventional ventilation strategies.
HFOV can be used as a primary mode of ventilation or as a rescue therapy for patients who fail to respond to conventional ventilation. It is often initiated when patients exhibit severe respiratory distress, hypoxemia, or signs of impending respiratory failure. HFOV may also be used prophylactically in high-risk patients to prevent the development of ARDS or other complications.
Despite its potential benefits, HFOV requires careful patient selection, monitoring, and management to optimize outcomes.
How to ventilate COPD and ARDS in Intensive care unit. safe lung ventilation. PEEP, Tidal volume, mode of ventilation. limits of ventilation. ventilator alarms
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
High-frequency oscillatory ventilation (HFOV) is an advanced mechanical ventilation strategy utilized in the management of respiratory failure, particularly in critically ill patients. It employs small tidal volumes delivered at rapid rates to maintain lung recruitment and gas exchange while minimizing the risk of ventilator-induced lung injury (VILI). HFOV is commonly employed in neonates, infants, and adults with acute respiratory distress syndrome (ARDS) or other conditions characterized by severe respiratory compromise.
The fundamental principle of HFOV involves the delivery of very small tidal volumes (often in the range of 1-3 mL/kg) at high frequencies (typically between 3 and 15 Hz). This approach differs from conventional mechanical ventilation, where larger tidal volumes are delivered at slower rates. The goal of HFOV is to provide adequate ventilation and oxygenation while minimizing the risk of lung injury associated with high tidal volumes and pressures.
In HFOV, gas is delivered into the airways in the form of rapid oscillations, creating small pressure changes that promote lung recruitment and gas exchange. These oscillations are superimposed on a baseline level of continuous positive airway pressure (CPAP), which helps to maintain lung volume and prevent atelectasis during expiration. The combination of high-frequency oscillations and continuous positive pressure facilitates gas exchange by improving alveolar ventilation and reducing intrapulmonary shunting.
The oscillations in HFOV are typically generated by a piston or a diaphragm within the ventilator circuit. The rapid oscillatory motion of the ventilator creates pressure fluctuations that are transmitted to the airways, causing the lungs to expand and contract at high frequencies. This cyclical stretching and relaxation of the lung tissue help to open collapsed alveoli, redistribute lung volume, and improve overall lung compliance.
One of the key advantages of HFOV is its ability to deliver ventilation while minimizing the risk of VILI. By using very small tidal volumes and high frequencies, HFOV reduces the mechanical forces applied to the lungs, thereby decreasing the likelihood of barotrauma (pressure-related lung injury) and volutrauma (overdistension of the alveoli). This makes HFOV particularly suitable for patients with ARDS or other conditions where lung injury may be exacerbated by conventional ventilation strategies.
HFOV can be used as a primary mode of ventilation or as a rescue therapy for patients who fail to respond to conventional ventilation. It is often initiated when patients exhibit severe respiratory distress, hypoxemia, or signs of impending respiratory failure. HFOV may also be used prophylactically in high-risk patients to prevent the development of ARDS or other complications.
Despite its potential benefits, HFOV requires careful patient selection, monitoring, and management to optimize outcomes.
How to ventilate COPD and ARDS in Intensive care unit. safe lung ventilation. PEEP, Tidal volume, mode of ventilation. limits of ventilation. ventilator alarms
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
1. H i g h F re q u e n c y
Oscillator y Ventilation
DR JEEWANA PRASAD
N I C U T H K 2 0 2 4
2. OBJECTIVES
• Introduction to High frequency ventilation
• Indications for HFOV
• Review of ventilator associated Lung Injury &
Respiratory Mechanics Related to HFOV
• Optimising oxygenation and ventilation
• Routine Management of the Patient on HFOV
3. WHAT IS HIGH FREQUENCY
VENTILATION?
? Alternative to Conventional Ventilation
4. HFOV
• Uses smaller tidal volumes - < Dead space
• Higher respiratory rates
• Lower proximal airway pressures
• Preservation of lung tissue
• Minimizes VALI
5. INDICATIONS FOR HFOV
Prophylaxis
• Reduced compliance
• RDS/ ARSD
• Meconium aspiration
• Air Leak
• BPD
• Pneumonia
• Atelectasis
• PPHN
Rescue
• Inadequate oxygenation that cannot safely
be treated without potentially toxic
ventilator settings and, thus, increased risk
of VALI.
• Objectively defined by:
• Peak inspiratory pressure (PIP) > 30-35
cm H2O
• FiO2 > 0.60 or the inability to wean
• Mean airway pressure (Paw) > 15 cm
H2O
• Peak end expiratory pressure (PEEP) >
10 cm H2O • Oxygenation index > 13-15
7. VENTILATOR ASSOCIATED LUNG INJURY
• All from of positive pressure ventilation can cause
lung injury
• IT can be
• Barotrauma
• Volutrauma
• Atelectrauma
• Biotrauma
8. BAROTRAUMA
• High airway pressure during positive pressure
ventilation can cause lung over distension with
gross tissue damage.
• Clinically, barotrauma presents as
pneumothorax, pneumomediastinum,
pneumopericardium, and subcutaneous
emphysema.
9. VOLUTRAUMA
• Lung overdistension can cause diffuse alveolar
damage at the pulmonary capillary membrane.
• This may result in increased epithelial and
microvascular permeability, thus, allowing fluid
filtration into the alveoli (pulmonary edema).
• Excessive end-inspiratory alveolar volumes are the
major determinant of volutrauma.
10. ATELECTRAUMA
• Mechanical ventilation at low end-expiratory
volumes may be inefficient to maintain the alveoli
open.
• Repetitive alveolar collapse and reopening of the
under-recruited alveoli result in atelectrauma.
• The quantitative and qualitative loss of surfactant
may predispose to atelectrauma.
12. HFOV
• Rate 400-2400 breath per min
• Usually measured in hurts
• Very small tidal volumes that are smaller
than dead space
• Active exhalation
13.
14. HFOV
• During CMV, there are swings
between the zones of injury from
inspiration to expiration.
• During HFOV, the entire cycle
operates in the “safe window” and
avoids the injury zones.
15.
16. PRESSURE TRANSMISSION
• With CMV, the pressures exerted
by the ventilator propagate
through the airway with little
dampening.
• • With HFOV, there is attenuation
of the pressures as air moves
toward the alveolar level.
• • Thus, with CMV the alveoli
receive the full pressure from the
ventilator. Whereas in HFOV, there
is minimal stretching of the alveoli
and, therefore, less risk of trauma.
17. INITIAL SETTINGS OF HFOV
• MAP = Conventional MAP +5
• ∆P -Until mid thigh is shaking
• Frequency
• <2000g 15Hz
• 2-12Kg 10Hz
18. THEORY OF HFOV
• Gas Transport Mechanisms
• Oxygenation
• Ventilation
19.
20. • Probably a little of all the theories all happening at
• the same time is the complete answer
• – Still don’t have a “formula” to predict alveolar
• ventilation with High Frequency Oscillation
• – Most important thing to note that it works, and
• works well and reasonably safely
27. CHEST RADIOGRAPH
• Initial x-ray at 1-2 hrs to determine the
baseline lung volume on HFV (aim for 7-8
ribs)
• A follow-up chest x-ray in 4-6 hours is
recommended to assess the expansion.
• Daily Xray are recommended
• Repeat Xray with acute changes
28. WEANING OF HFOV
• Reduce FiO2 to <40%
• Reduce MAP
• Wean the amplitude
• Do not wean the frequency
• Switch to conventional ventilation
• – MAP<10cmHO,
• – Amplitude20-25
• – blood gases satisfactory
29. LIMITATIONS
•HFOV is non physiological ventilation
•Need good sedation
•ET tube blocks are very common
needing frequent suction and re
intubation
30. T h a n k
Yo u
01
YOUR MARKETING COMPANY OR A TOPIC
C O M P A N Y N A M E 2 0 2 4
