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Mechanical ventilation in obese patients according to the i-STAR Algorithm Intubate • Anticipate difficult airway management and
and difficult mask ... 5 cmH20 in non-ARDS ... Gradually lower Fi02 ... recruitment • FiO2 ... desaturation prioritise FiO2
Mask Oxygen Delivery Devices Simple Mask aka Hudson's Mask: • Flow 6-10 LPM • FiO2 35-50% Face Tent:
10-15 LPM • FiO2 ... provide a different FiO2 ... Flow 2-15 LPM • FiO2 ... 10-15 LPM • FiO2 ... 10-15 LPM • FiO2
PROSEVA definition of ARDS Thus, the PROSEVA trial essentially modifies the Berlin definition of ARDS, with the
definition of ARDS ... definition of ARDS ... that the PaO2/FiO2 ... that the PaO2/FiO2 ... #CriticalCare #ARDS
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 Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS) - Respiratory symptoms must have begun within one
Distress Syndrome (ARDS ... severity of the ARDS ... mm Hg < PaO2 / FiO2 ... mm Hg < PaO2 / FiO2 ... >= 5cm H2O #ARDS
Understanding & Treating ARDS - Acute Respiratory Distress Syndrome • Timing - within one week of
Understanding & Treating ARDS ... Oxygenation PaO2/FiO2 ... @nickmmark #ARDS
Oxygen Delivery Systems Nasal Cannula: • Flow: 1 - 6 L/min • FiO2: 25 - 40% (-4%/L
- 6 L/min • FiO2 ... of flow) Face Mask ... - 10 L/min • FiO2 ... - 15 L/min • FiO2 ... ~40% Venturi Mask
Oxygen Delivery by Device Nasal Cannula • Indicated for low-flow, low-percentage supplemental oxygen. • Flow rate of
high percentage FiO ... Venturi Mask (venti-mask ... set to desired FiO2 ... deliver desired FiO ... Oxygen #Delivery #FiO2
Approach to the A-a Gradient A-a gradient = PAO2 - PaO2 A-a gradient = [FiO2 x (Patm -
A-a gradient = [FiO2 ... chest) • Low PiO2 ... Elevation, Low Fio2 ... : Atelectasis, ARDS
Acute Respiratory Distress Syndrome – ARDS: Clinical Cheat Sheet An acute diffuse, inflammatory lung injury, leading to
Distress Syndrome – ARDS ... or CXR ● PaO2/FiO2 ... sepsis-associated ARDS ... days after dx of ARDS ... RespiratoryDistress #Syndrome #ARDS
Oxygen Delivery Devices - Comparison Low Flow: • Nasal cannula (1-6L, 24-40% FiO2) • Face mask (5-10L,
(1-6L, 24-40% FiO2 ... ) • Face mask ( ... 5-10L, 35-60% FiO2 ... Face tent/shovel mask ... ) • Venturi mask
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