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VentSim Vs. Mechanical Ventilation Expert

VentSim im Vergleich zu Mechanical Ventilation Expert Nutzung und Statistiken

VentSim is a fully functioning, high fidelity, physiologically faithful mechanical ventilator simulator. It was developed by Dr. Roger Stedman for iOS using the Swift programming language. Its purpose is an educational tool for critical care doctors, nurses, therapists, and anaesthetists – essentially anyone that has an interest in the provision of safe, effective care of the mechanically ventilated patient. VentSim uses a mathematical model of the human respiratory system (volumes, resistance and compliance) which are well established models published in the literature [link]. These have been codified with an interface developed which allows you to manipulate parameters to simulate different patient scenarios (everything from a neonate through to an adult with severe COPD and emphysema). VentSim allows you to apply ventilator settings to your respiratory system model and then generates pressure, volume and flow signals that are displayed on your iOS device. Using VentSim On launch VentSim takes you straight into the simulator view – this is your central navigation point for the app. Set up your simulated patient Tap the ‘Patient’ button on the right side of the navigator bar. This brings up the ‘Patient Settings’ view: The controls will slide in from the right, allowing you to still see some of the simulator view as you make adjustments. Select your type of patient - and then adjust weight and relative lung volume size. You will see calculated lung volumes. Select linear or dynamic compliance If linear is selected adjust the ‘Compliance Slider’ (mls/cmH2O). Alternatively - explore the dynamic compliance model and try different compliance models. Adjust the Time constant, this will adjust airway resistance according to the size and compliance of your patient. Return to the simulator view by tapping the right arrow in the navigator bar. Adjust your ventilator settings Select the ‘Ventilator’ button to the left of the navigator bar. This brings up the ‘Ventilator Settings’ view: Select your ventilator rate (bpm) and I:E ratio using the sliders. You have a choice of three ventilator modes; Pressure Control, Volume Control and Flow Control. You are able to adjust appropriate input values for each of these (Inspiratory pressure, tidal volume or inspiratory flow) as well as apply PEEP and in volume control mode add an end inspiratory pause. Return to the simulator view to view the impact your settings have had on your patients respiratory parameters. Optimise the simulator view If you are finding that due to screen size information is hidden (as is the case with the iPhone SE) try turning your device on its side into landscape mode. The simulator view in landscape mode on an iPhone SE Each simulator graph view has a gear icon in the top right hand corner, tap this to bring up the view settings panel. This allows you to change the background color, plot color, speed of animation, animation type (default is the wrap fade mode) and plot style (line or solid). Graph Plot View settings popover You will notice that as you change your settings the graph plots will automatically re-scale to an optimum screen fit. The axis labels will adjust accordingly. The panel data is updated at the end of each respiratory cycle. Other Features The ‘i’ (information) button on the navigator bar opens a mini-browser which navigates automatically to this page. The down pointing chevron button on the navigator opens a menu with which to access other features of the simulator which allows you to switch on and off each individual view and also add in the spirometer loop view and also the compliance view. Have fun! Please feedback to: ventsim@rogerstedman.com ventsim@rogerstedman.com

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Mechanical Ventilation Expert

Caution! This app is intended for intensive care physicians. If you are NOT a physician and would like to use it anyway, please consult your physician before using this app or making any medical decisions. This app has endorsement for usage in the Russian Federation. Many doctors deal with the treatment of patients with varying degrees of acute respiratory failure (ARF). But the choice of the optimal method and, especially, the timely correction of the parameters of invasive and non-invasive mechanical lung ventilation often cause difficulties, especially for young doctors. Unfortunately, expensive ventilation machines, without their skillful use, are not a guarantee of an improvement in the mortality rate in ARF. This has been especially evident during the COVID-19 pandemic. In international clinical practice, it is customary to determine the degree of ARF by the oxygenation index (the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the fraction of inspired oxygen (FiO2)). This indicator is also included in most "severity of illness" scoring systems (SOFA, APACHE II-III, etc.). However PaO2 estimation is only possible after collecting the arterial blood for laboratory monitoring of blood gases, making it costly and invasive. In 2020-2021 a multicenter research was carried out at five clinical hospitals in Volgograd, Russia, which included 1038 patients with acute lung injury and acute respiratory distress syndrome against the background of viral (COVID-19) and bacterial pneumonia. The goals of the research were firstly, to develop a non-invasive method for determining the oxygenation index (PaO2 / FiO2) based on oxygen saturation (SpO2), and secondly, to define general criteria for correcting the parameters of invasive and non-invasive mechanical ventilation. This application is based on the results of the research. The relationship between SpO2 and PaO2 index values was determined for various FiO2 and types of respiratory support. The app also implements the general principle of oxygen therapy - from less to more invasive. The app allows the user not only to choose the most effective method of respiratory support, but also timely learn about the need for its correction. Every clinician knows that the mortality rate in patients with ARF is greatly influenced by the validity of the beginning and end of Invasive Mechanical Ventilation treatment - and this app solves this problem. The educational effect of this app should also be noted. It will help doctors to quickly master and more competently use expensive ventilation machines, which, of course, will have a beneficial effect on the results of treatment of patients with ARF. The following sources were used to create the app: 1. Brown SM, Grissom CK, Moss M, Rice TW, Schoenfeld D, Hou PC, Thompson BT, Brower RG; NIH/NHLBI PETAL Network Collaborators. Nonlinear Imputation of Pao2/Fio2 From Spo2/Fio2 Among Patients With Acute Respiratory Distress Syndrome. Chest. 2016 Aug;150(2):307-13. doi: 10.1016/j.chest.2016.01.003. Epub 2016 Jan 19. PMID: 26836924; PMCID: PMC4980543. 2. Bilan N, Dastranji A, Ghalehgolab Behbahani A. Comparison of the spo2/fio2 ratio and the pao2/fio2 ratio in patients with acute lung injury or acute respiratory distress syndrome. J Cardiovasc Thorac Res. 2015;7(1):28-31. doi: 10.15171/jcvtr.2014.06. Epub 2015 Mar 29. PMID: 25859313; PMCID: PMC4378672. 3. Yoshida T, Takegawa R, Ogura H. [Ventilatory strategy for ARDS]. Nihon Rinsho. 2016 Feb;74(2):279-84. Japanese. PMID: 26915253. 4. Fan E, Brodie D, Slutsky AS. Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment. JAMA. 2018 Feb 20;319(7):698-710. doi: 10.1001/jama.2017.21907. PMID: 29466596. 5. Петров, В. И. Эволюция клинико-фармакологических и терапевтических принципов лечения инфекции COVID-19 / Петров В. И. [и др. ]. - Москва : ГЭОТАР-Медиа, 2021. - 312 с. - DOI: 10.33029/9704-6386-4-ECPC-2021-1-312. - ISBN 978-5-9704-6386-4.