@@thenicudoc yes!! ❤️ I worked in the NICU for a year at a level 3 but we only functioned at a level 2! I'm looking for a level 3/4 nicu job now so hopefully I'll get something soon, also working on my Nps.
I dont have experience with jet ventilation. Just the oscilador. Wich is not used The way it should in the units i work. Specially for the premies i mean. Follow your work form Rio, Brasil. Keep it up.
My pleasure. A tip...think MAP = PEEP, AMP = PIP. Hz and Rate is a little different concept...as ine is more the area under the curve (hz) while the other is more about expiratory ratios and allowing more relaxation time (rate).
I was wondering why you would order an amplitude rather than power. Amplitude is variable and can fluctuate given changes in lung compliance and airway resistance. I know this is an eternal debate just would love to hear your opinion.
You're not wrong. It is similar to the debate of VG vs. PC. Some swear by one vs. the other and in certain populations, it makes a difference. Bit the majority, it really doesn't make any physiological difference.
Hi there, thanks for the video. If I can have a question...what would be your next step if you had a baby on MAP 10, Amp 20, with dangerously low pCO2, and actually needed less than 1:2 ratio? Would you switch to AC, or increase frequency? Or decrease amplitude a little and possibly risk atelectasis anyway? Because what you are saying with the ratio and atelectasis definitely makes sense, but people do still go low with amplitude (basiscally almost to the point where chest wiggle stops), and only then change the frequency, and later on possibly I:E ratio.
Great question. Personally, I would ask myself...do we need to be mechanically ventilated. If all parameters exist, you CAN extubate from high frequency. If you need to remain intubated, then go up on frequency until 15. If already there, then switch to mechanical vent. Hope this helps
@@thenicudoc thanks it helped. And id love to ask you two more question, have ever used frequency higher than 15? Maybe with babies under 400g? And have you ever used hfov+cmv regime? So called Combined oscillatory and mandatory ventilation for sever respiratory failure resistant to hfov? SLE6000 offers this mode, but the date is scarce.
I've been checking out your videos, they are super helpful please keep them coming. I need to know everything nicu! ❤️
Thank you Ms. Bianca. Glad you liked. Why do you need to know? Entering the NICU workforce?
@@thenicudoc yes!! ❤️ I worked in the NICU for a year at a level 3 but we only functioned at a level 2! I'm looking for a level 3/4 nicu job now so hopefully I'll get something soon, also working on my Nps.
Ty a lot for the review Dr Fort!
It is my absolute pleasure. Do you like the oscillator or the Jet best?
I dont have experience with jet ventilation. Just the oscilador. Wich is not used The way it should in the units i work. Specially for the premies i mean. Follow your work form Rio, Brasil. Keep it up.
Thanks for this video! I was trained with the jet, so I’m trying to get more familiar with the oscillator.
My pleasure. A tip...think MAP = PEEP, AMP = PIP. Hz and Rate is a little different concept...as ine is more the area under the curve (hz) while the other is more about expiratory ratios and allowing more relaxation time (rate).
This is very helpful video+ the tip you always give towards the end
Excellent. Thank you for that feedback 😊.
Excellent NICU Doc..
thank you so much for that kind comment
Good stuff. Well put together
That really means a lot. Thank you so much
I was wondering why you would order an amplitude rather than power. Amplitude is variable and can fluctuate given changes in lung compliance and airway resistance. I know this is an eternal debate just would love to hear your opinion.
You're not wrong. It is similar to the debate of VG vs. PC. Some swear by one vs. the other and in certain populations, it makes a difference. Bit the majority, it really doesn't make any physiological difference.
Hi there, thanks for the video. If I can have a question...what would be your next step if you had a baby on MAP 10, Amp 20, with dangerously low pCO2, and actually needed less than 1:2 ratio? Would you switch to AC, or increase frequency? Or decrease amplitude a little and possibly risk atelectasis anyway? Because what you are saying with the ratio and atelectasis definitely makes sense, but people do still go low with amplitude (basiscally almost to the point where chest wiggle stops), and only then change the frequency, and later on possibly I:E ratio.
Great question. Personally, I would ask myself...do we need to be mechanically ventilated. If all parameters exist, you CAN extubate from high frequency. If you need to remain intubated, then go up on frequency until 15. If already there, then switch to mechanical vent. Hope this helps
@@thenicudoc thanks it helped.
And id love to ask you two more question, have ever used frequency higher than 15? Maybe with babies under 400g?
And have you ever used hfov+cmv regime? So called Combined oscillatory and mandatory ventilation for sever respiratory failure resistant to hfov? SLE6000 offers this mode, but the date is scarce.
@aron7765 Going beyond 15 decreases the Itime, so we don't go above 15. No...never heard of HFOV with CMV. Kinda defeats the purpose of the HFOV.