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| Image from: http://www.esicm.org |
“Strategies in Difficult Intra-Operative Ventilation” was a
continuing education course originally presented at the 2012 American Academy
of Anesthesiologist convention.
Now the
course is available online through the ASA website for continuing education units. I would not recommend this course for the ICU practitioner because it overviews strategies that we practice daily or weekly, however for the anesthesia provider that is not familiar with lung protective strategies the course may be beneficial.
Below is a synopsis of the course and a hyperlink to the website.
This course is divided into four separate lectures;
WHAT DO PEOPLE
ACTUALLY DO?
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Summary
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Overviewed current strategies for management of mechanical
ventilation in the OR.
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Conclusion
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-During hypoxic episodes practitioners increase the FiO2, set tidal
volume, and then lastly PEEP.
-In the OR, patients’ with ARDS are ventilated with higher tidal
volumes, higher FiO2’s, & lower PEEP. Compared to ICU ventilation
strategies.
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Significance
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Anesthesia Practitioners are still behind in regards to lung
protective ventilation, and techniques to improve oxygenation.
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STRATEGIES for
MONITORING MECHANICAL VENTILATION
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Summary
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-Presented what happens in regards to pulmonary mechanics during
general anesthesia.
-Overview of common monitoring devices (including- SPO2, capnography,
& ventilator waveforms) that are currently in use to assess the patient and
optimize ventilator settings.
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Conclusion
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Use monitoring to facilitate in optimize settings & identify
potential complications.
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Significance
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Anesthesia providers can utilize these monitoring techniques in their
daily practice to optimize ventilator settings.
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INTRA-OPERATIVE
VENTILATION in PATIENTS’ with ARDS
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Summary
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Presented the definition of ARDS, differentiated between
extra-pulmonary versus pulmonary ARDS and over-viewed the significance of
various techniques in ventilating the patient with ARDS.
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Conclusion
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Target goals when ventilating the patient with ARDS.
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Significance
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Anesthesia providers may have to provide anesthesia for the ICU
patient with ARDS. Lung protective strategies are very different then
standard techniques.
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GETTING it DONE
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Summary
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Presented a case study of an ICU patient with sepsis (question and
answer format). Overviewed clinical pearls and potential pitfalls.
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Conclusion
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Always evaluate your patient thoroughly before just merely
transporting the patient and switching ventilator modes. Current ICU
ventilator settings may not provide the entire picture of the patient’s
clinical status.
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Significance
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The anesthesia ventilator may work differently than the ICU
ventilator.
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Course Link: http://education.asahq.org/2012-highlights/DIV
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