Monday, February 6, 2012

"It's a Nail"

“Spoils of War” by Andy Ihnatko 2009.

 A colleague of mine described a presentation she attended today in which the speaker was describing the usefulness of the “Dynamic Lung” and how there was no use for those squiggly little lines (referring to ventilators waveforms).

Is this guy serious?

This reminds me of an old saying “to the man with only the hammer, every problem looks like a nail”.

This presenter clearly just has a hammer in his tool box and is biased or unaware of the additional benefits of ventilator waveform monitoring. Yes, the Dynamic lung is an easy to use graphic that provides real time data on changes in pulmonary mechanics, EtCO2, and spontaneous efforts.

However, the Dynamic lung cannot show trigger, flow, cycle, or expiratory asynchronies.

The Dynamic lung will show changes in pulmonary mechanics; however it does not show the cause.

Did resistance go up due to bronchospasm or a clogged HME or expiratory filter?

Did compliance drop due ARDS or did that RN just give a 1000 ml of fluid?

There EtCO2 is much lower, is it hyperventilation or a major decrease in cardiac output.

Yes it would be nice to have graphics that provided all the information, however it is not the Dynamic Lung.

Stop trying to present these shallow viewpoints, critical care medicine is difficult and utilizes various medical specialties.

The Intensivist requires a vast assortment of tools, using multiple assessment skills to treat their patients; there are no panaceas in the ICU.