Dr. Gerald Diaz @GeraldMD
48.7M 14.2K 7.5K
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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BiPAP titration in CHF
 - Mean airway pressure provides goodness 
 - Ramp up the ePAP
BiPAP titration ... Driving pressure supports ... CongestiveHeartFailure #Management ... #CriticalCare # ... Cardiology
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
Support: -The role ... support is generally ... support isn't to ... #Management #CriticalCare ... RespiratorySupport #Selection #Algorithm
Noninvasive Positive Pressure Ventilation (NIPPV)

Expiratory & Inspiratory Positive Airway Pressure
Both increase intrathoracic pressure, which can decrease
mortality, LOS NIPPV Indications ... exacerbation (cardiogenic pulmonary ... Pt is DNI with indication ... #indications #criticalcare ... #management
Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications
Indications for NIV:
 • COPD - pH <7.35, pCO2
Non-Invasive Ventilation (BiPAP ... ) Algorithm - Indications ... Neuromuscular disease - Respiratory ... #Algorithm #criticalcare ... #management #indications
COVID-19 Hypoxia Management

Indication for endotracheal intubation?
Tolerating supplemental oxygen?
Consider HFNC
Not tolerating HFNC or HFNC is not available?
Consider
Indication for ... Guidelines #respiratory ... #support #COVID19 ... #criticalcare # ... hypoxia #failure #algorithm
Non-Invasive Positive Pressure Ventilation
Indications: 
 • COPD exacerbation (↓ intubation, ↓ mortality), Cardiogenic pulmonary edema (↓
), Cardiogenic pulmonary ... Other causes of respiratory ... a.k.a BiLevel, BiPAP ... Ventilation #diagnosis #management ... #indications #pulmonary
Noninvasive Ventilation Summary
Positive pressure ventilation that is delivered through a nasal, mask, or helmet interface and
breathing by improving pulmonary ... pressure throughout respiratory ... oxygenation BIPAP ... #Ventilation #management ... #pulmonary
Management of interstitial lung disease (ILD)-associated with systemic sclerosis (SSc)

Therapeutic indication: absolute decline in FVC >10%
Management of interstitial ... stop,nutritional support ... systemicsclerosis #SSc #pulmonary ... #indications #management ... #treatment #algorithm
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
General schema for respiratory ... support in patients ... #management #schema ... #criticalcare # ... hypoxia #failure #algorithm
Proposed Respiratory Support Algorithm in COVID19

The ‘intubate early’ paradigm, where patients who “fail” low flow oxygen
Proposed Respiratory ... Support Algorithm ... #support #COVID19 ... #management #schema ... #criticalcare #