Pulmonology

Kit's Hyperoxia Lecture: https://youtu.be/d3-bTZ8Fclw or https://www.youtube.com/watch?v=TKbOgCYfveE&feature=youtu.be

PEEP recruitment video: https://www.youtube.com/watch?v=oKH7CtsEgHw

Transpulmonary pressure video: https://www.youtube.com/watch?v=CKz5QdCgjVo

p_AO_2=F_IO_2(P_{ATM}-pH_2O)-\frac{p_aCO_2(1-F_IO_2[1-RQ])}{RQ}

pAO2 = 107 mmHg if FIO2 = 0.21 mmHg, PATM = 760 mmHg, pH2O = 47 mmHg, paCO2 = 40 mmHgRQ (RER) = 0.8

Approximate PAO2 = FiO2 x 500 mm Hg

Approximate PaO2 to SaO2 Conversion

 PaO2  O2 Sat
 ≥ 90 mm Hg  100%
 60 mm Hg  90%
 30 mm Hg  60%
 27 mm Hg  50%


Mech ventilated patients have a dead space to alveolar ratio of 1:1 as opposed to the 1:2 in a normal patient Va for a normal CO2 is 60 cc/kg/min, so we need to double that (120 cc/kg/min)

Static Lung Compliance (mL/cmH2O) = Tidal Volume / (PIP - PEEP)


Acute Pulmonary Edema Pathophysiology


West Zones




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1000 pts, NIV no change in 7d mortality or intubation rate   236k v. 3 Aug 14, 2011, 8:11 AM Kit Tainter
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  1418k v. 1 Oct 16, 2015, 10:01 AM Kit Tainter
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  150k v. 1 Oct 15, 2013, 4:26 AM Kit Tainter
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  182k v. 1 Nov 30, 2010, 11:19 AM Kit Tainter
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JAMA meta-analysis Low Vt benefit non-ARDS pts  262k v. 1 Oct 30, 2012, 1:28 AM Kit Tainter
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No Abx for aspiration pneumonitis  103k v. 3 Oct 12, 2010, 11:25 AM Kit Tainter
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  743k v. 1 May 10, 2016, 10:20 PM Kit Tainter
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Murray > 3.0 or pH < 7.2 benefit from ECMO  199k v. 1 Aug 22, 2013, 8:23 AM Kit Tainter
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Decreases mortality RR 0.52, intubation RR 0.41, complications RR 0.38, and length of stay 3.24 days  807k v. 1 Aug 22, 2011, 11:57 AM Kit Tainter
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  351k v. 1 Feb 16, 2017, 10:55 AM Kit Tainter
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  325k v. 1 Oct 10, 2015, 5:10 PM Kit Tainter
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  97k v. 1 Feb 5, 2014, 1:47 PM Kit Tainter
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Meta-analysis NIV decreases intubation and improves mortality   255k v. 3 Aug 14, 2011, 8:10 AM Kit Tainter
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  641k v. 1 Aug 5, 2013, 5:15 AM Kit Tainter
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Preoxygenation with NIV produced better oxygenation and fewer desats compared to BVM  148k v. 1 Aug 5, 2013, 5:19 AM Kit Tainter
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Includes review of hyperoxia  1021k v. 1 Apr 27, 2013, 4:20 PM Kit Tainter
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Excellent review of the hemodynamic effects of PEEP  866k v. 1 Mar 19, 2016, 10:37 AM Kit Tainter
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  50k v. 1 Nov 2, 2015, 12:23 PM Kit Tainter
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