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- Mechanical Ventilation Expert Vs. VentilO
Mechanical Ventilation Expert im Vergleich zu VentilO Nutzung und Statistiken
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.
- Apple App Store
- Kostenlos
- Medizin
Rang speichern
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The VentilO application is a mobile educational application that allows healthcare professionals in charge of patients with mechanical ventilation:
(i) to learn how to set the initial ventilatory settings in volume-controlled ventilation mode based on several parameters,
(ii) to reason about the influence of different parameters on ventilatory needs in adult patients,
(iii) to learn about optimization of ventilator settings for oxygenation, lung protection and CO2 elimination
(iv) to learn about the impact of dead space on ventilation efficiency.
The initial settings for minute ventilation (tidal volume (VT) and respiratory rate (RR)) will be proposed. The VT will be determined according to the predicted body weight, the body temperature and the type of patient (medical or surgical). VT/RR combinations for different targets of VT (3 to 10 mL / kg PBW will be provided, settings from 6 to 8 mL/kg PBW will be preferred). Educational texts are proposed to help other settings (PEEP and FiO2) in the different care contexts.
‘’Optimizing settings’’ is covered in another separate tab. Will provide calculation of several parameters (alveolar ventilation, dead space…) based on the patient’s data, ventilator settings and arterial blood gases results. In addition interpretations will be provided for Oxygenation, Ventilation (CO2) and Lung protection.
In another separate tab ‘’Tools&Calculators’’, several tools are provided:
-Impact of the instrumental is explained in details. Minute ventilation and alveolar ventilation (minute ventilation - dead space ventilation) are calculated. The physiological dead space is calculated according to published formulas linked to the predicted body weight of the patients, the instrumental dead space (linked to the volumes of the endotracheal tubes, connections, heat and moisture exchangers) is calculated. The impact of reducing dead space on several parameters is calculated (gain in alveolar ventilation, gain in reduction in tidal volume (and associated reduction in plateau pressure),or respiratory rate with constant alveolar ventilation)
- Different Calculators (P/F ratio from SpO2, PBW…)
-Links to several additional tools (Quick Reference Respiratory Care Card; O2 demand calculator, Recruitment to Inflation Ratio…)
In addition to the measurements of these different parameters, several educational texts are accessible in the application to understand what dead space is during mechanical ventilation, what is instrumental dead space, what is the impact of dead space in function of ventilation settings and possible gains.
These calculations and descriptions concern ventilated adult patients, in the emergency room, intensive care units and in the operating room. The VentilO application was developed with the help of several mechanical ventilation experts.
The mobile application is trilingual (English, French and Spanish), based on the users settings.
- Apple App Store
- Kostenlos
- Medizin
Rang speichern
- -
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Dezember 2, 2024