Dr. Gerald Diaz @GeraldMD
48.6M 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 ... BiPAP titration ... CongestiveHeartFailure #Management ... #CriticalCare # ... Cardiology
Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications
Indications for NIV:
 • COPD - pH <7.35, pCO2
Non-Invasive Ventilation ... (BiPAP) Algorithm ... #BiPAP #Algorithm ... #criticalcare # ... management #indications
Noninvasive Positive Pressure Ventilation (NIPPV)

Expiratory & Inspiratory Positive Airway Pressure
Both increase intrathoracic pressure, which can decrease
Positive Pressure Ventilation ... exacerbation (cardiogenic pulmonary ... PositivePressure #Ventilation ... #indications #criticalcare ... #management
Severe Asthma Exacerbation
Signs of a Severe Asthma Exacerbation:
 • Vitals: ↑HR ↑RR ↓SpO2
 • High work
Prednisone • NIPPV: BiPAP ... • Initial ventilator ... #Exacerbation #CriticalCare ... #pulmonary #ventilation ... #mechanical #management
Non-Invasive Positive Pressure Ventilation
Indications: 
 • COPD exacerbation (↓ intubation, ↓ mortality), Cardiogenic pulmonary edema (↓
Positive Pressure Ventilation ... Indications: ... a.k.a BiLevel, BiPAP ... #diagnosis #management ... #indications #pulmonary
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
-The choice of BiPAP ... #Management #CriticalCare ... #BiPAP #BiLevel ... #Noninvasive #Ventilation ... RespiratorySupport #Selection #Algorithm
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Mechanical Ventilation in High Intracranial Pressure (ICP)
- Maintain PEEP < ICP
- Dealing with ICP
- HOB effect
Mechanical Ventilation ... Post-intubation Management ... #Mechanical #Ventilation ... ICP #Elevated #management ... #pulmonary #criticalcare
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
positioning • Exact indication ... VV-ECMO • indicatons ... support #COVID19 #management ... #schema #criticalcare ... hypoxia #failure #algorithm
COVID-19 Intubation Checklist

Personal protective equipment (PPE)
 • Standard PPE
   • N95 or PAPR.
Medications & pre-planned ... include: • BiPÅP ... • If using BiPÅP ... Checklist #SARSCoV2 #Management ... #CriticalCare #
Management of interstitial lung disease (ILD)-associated with systemic sclerosis (SSc)

Therapeutic indication: absolute decline in FVC >10%
Management of interstitial ... Therapeutic indication ... systemicsclerosis #SSc #pulmonary ... #indications #management ... #treatment #algorithm