PronePositioning

🫁 Understanding PEEP in ARDS: The Balance Between Recruitment and Overdistension 🫁 Positive End-Expiratory Pressure (PEEP) plays a crucial role in managing patients with ARDS, particularly in those with moderate-to-severe cases (PaO2/FiO2 < 150 mmHg). The first image brilliantly captures the complex balance between beneficial effects, like alveolar recruitment and decreased pulmonary vascular resistance, and potential drawbacks, such as alveolar overdistension and increased pulmonary vascular resistance. This balance hinges on lung recruitability, which dictates whether PEEP will optimize oxygen delivery or compromise hemodynamics. In the second image, we see a practical approach to PEEP titration in ARDS management. It emphasizes a personalized therapy strategy, where the risk-benefit assessment of PEEP is continuously monitored through various clinical parameters—respiratory mechanics, hemodynamics, arterial blood gases, and more. For refractory cases, prone positioning and V-V ECMO are highlighted as advanced interventions to optimize oxygen delivery. Key takeaways: 🔹 PEEP titration should always be personalized based on lung injury patterns, recruitability, and hemodynamics. 🔹 Monitoring and adjusting PEEP, especially in severe cases, can make a significant difference in outcomes. Let’s continue to innovate and personalize care for our most vulnerable patients! 💙 <a href="/search?f=tweets&q=#ARDS">#ARDS</a> <a href="/search?f=tweets&q=#CriticalCare">#CriticalCare</a> <a href="/search?f=tweets&q=#MechanicalVentilation">#MechanicalVentilation</a> <a href="/search?f=tweets&q=#PEEP">#PEEP</a> <a href="/search?f=tweets&q=#LungProtection">#LungProtection</a> <a href="/search?f=tweets&q=#ECMO">#ECMO</a> <a href="/search?f=tweets&q=#PronePositioning">#PronePositioning</a> For more in depth understanding read further <a href="https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-05059-y">ccforum.biomedcentral.com/ar…</a>

This tweet is unavailable

Shahla Siddiqui, MD, MSc, FCCM @shahlasi

28 Dec 2023

VV Ecmo negates the benefit of prone positioning

This tweet is unavailable

jie @JieLiRRT

18 Sep 2023

Thanks for AARC to invite me to present the honor lecture, I spent lots of time reviewing current fast-growing evidence on prone positioning. Learned a lot from @DrMiguelIbarra1 @claudeguerin rc.rcjournal.com/content/68/…

This tweet is unavailable

Dr. Miguel Ibarra-Estrada @DrMiguelIbarra1

27 Jun 2022

Just released! It's always a privilege to work with outstanding international researchers @JieLiRRT, @oriolrocag Lung ultrasound response to awake prone positioning | Critical Care | Full Text ccforum.biomedcentral.com/ar…