Peri-operative lung protective ventilation

 

Definition of ARDS:

Diagnosis

Berlin criteria:

1.       Acute

2.       Hypoxaemia

3.       Bilateral opacities

4.       Non-cardiogenic

Severity

·         Mild: P/F 2-3

·         Mod: P/F 1-2

·         Sev: P/F <1

 

Lung-protective ventilation:

Peri-op benefits

·           ↓Inflammatory markers

·           ↓Failed extubation

·           ↓Pneumonia

1.Prevent volutrauma

·           VT <6mL/kg

2.Prevent barotrauma

·           PPlat <30cmH2O

·           ∆P <15cmH2O

3.Prevent atelectrauma

·           PEEP 5-15cmH2O

4.Airway toilet

·           Suction pharynx

·           Suction trachea

 

Other management of ARDS

Positioning

·      Prone 16/24

Medication

·      Relaxant

·      Nitric

ECMO

·      Veno-venous

 

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