Tutorial 7: Ventilation, Ventilatory Failure, Ventilation Perfusion Matching and Dead Space

Описание: Clinicians who work in anesthesiology, intensive care or emergency medicine who are involved in the management of respiratory failure must understand the problem of failure to ventilate: "can't breathe, won't breathe." This long tutorial covers a lot of ground and could be viewed in split sessions. My principle goal is to give you the tools to work the problem of respiratory failure. Along the way I introduce the alveolar gas equation, ventilation perfusion matching and lung volumes; particularly functional residual capacity.
In the second half (from 28:20 onwards), I discuss anatomical and physiological dead space, calculate out the dead space to tidal volume ratio and show how you can be inadvertently increasing physiologic dead space by applying PEEP or neglecting auto-PEEP. Even if you think you know a lot about this subject, I guarantee that you will learn something.
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Content:
01:05 Review of Previous Tutorial (volume controlled modes)
01:40 Contents of this Tutorial
02:45 Clinical Scenario - Freida, in the operating room, not breathing
03:20 Why Do We Breathe?
04:25 Respiratory Failure
06:05 The Transit Airways
08:55 Normal Ventilation Perfusion Relations
11:30 Failure to Generate Adequate Alveolar Ventilation
18:20 Failure to Clear CO2 Despite Apparently Adequate Alveolar Ventilation
18:58 Alveolar Gas Equation
24:00 Lung Volumes
28:25 Dead Space to Tidal Volume Ratio
29:30 Ventilation Perfusion Matching and Distribution
37:20 Clinical Scenario Renewed
40:10 Dead Space Ventilation and Increased PaCO2
45:30 Clinical Scenario - Developments
47:25 Impact of PEEP on Ventilation Perfusion Matching
50:00 Auto-PEEP
53:30 Review
55:05 Preview of Next Tutorial (supplementary tutorial on end tidal CO2 monitoring)