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Monitoring Plateau Pressures

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by GilaRRT GilaRRT (Member)

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Over the last year or so I have seen allot of new info on ARDS. One of the concepts that people are starting emphasize is the plateau pressure. I know most people monitor the peak insp. pressure. I was curious to see how many providers are now monitoring the plateau pressure. It looks like the plateau pressure is very important when looking at the development of lung injury and ARDS.

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phiposurde has 9 years experience and specializes in critical care,flight nursing.

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New concept for me too. But we use it more as well. From my understanding, you can tell a few things with that number. It can be use in esthablishing alveoli recruitment to assess and determine the volume to give to recruit( see thread in MICU+SICU).It can help in problem shooting, if your peak airway is high but your plateau is normal the your trouble is in the airway( secretions,bronchoconstriction,ect). At least( which actually should be first but I though of it last8), It can help determine if you should use pressure or volume mode on the vetilator. If you have high plateau maybe pressure would be more safe to use then volume mode

Over the last year or so I have seen allot of new info on ARDS. One of the concepts that people are starting emphasize is the plateau pressure. I know most people monitor the peak insp. pressure. I was curious to see how many providers are now monitoring the plateau pressure. It looks like the plateau pressure is very important when looking at the development of lung injury and ARDS.

 

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phiposurde has 9 years experience and specializes in critical care,flight nursing.

120 Posts; 3,241 Profile Views

It is good to see somebody else using it. I do not see it catching on down where I live and work. Is this a trend in Canada?

*** Not sure if it is a trend. Like I just said, I am just discovering the use of that number. But some of our protocol are base on that level. The ICU i work for is pretty medicine base and pretty high up in the list of the best ICu( well that,s what the tell us8). So I presume if it,s not a trend it will become one.

 

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phiposurde has 9 years experience and specializes in critical care,flight nursing.

120 Posts; 3,241 Profile Views

It is good to see somebody else using it. I do not see it catching on down where I live and work. Is this a trend in Canada?

*** I found that maybe it could answer your question:

http://bja.oxfordjournals.org/cgi/content/full/92/2/296-a

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1 Article; 1,905 Posts; 15,766 Profile Views

Thank you. We are also trying to ventilate with much lower tidal volumes. We calculate our initial settings at 6-8 ml/kg of lean body weight.

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phiposurde has 9 years experience and specializes in critical care,flight nursing.

120 Posts; 3,241 Profile Views

Thank you. We are also trying to ventilate with much lower tidal volumes. We calculate our initial settings at 6-8 ml/kg of lean body weight.

*** That's part of our ARDS policy. Patient with"normal" lung. I believe we do the 8-10 ml/kg.

 

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