Friday night ventilation a safety starting tool kit for

Minerva anestesiologica · Sep 2014

Review

Friday night ventilation a safety starting tool kit for mechanically ventilated patients.

We wish to report here a practical approach to an acute respiratory distress syndrome (ARDS) patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. ⋯ PEEP from 5 to 10, from 10 to 15 and greater than 15 cmH2O should be set in mild, moderate and severe ARDS, respectively. Prone position should be applied in severe ARDS, if experience is available. In case of unchanged conditions or increased ARDS severity a referral center should be contacted.

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- L Gattinoni, E Carlesso, L Brazzi, M Cressoni, S Rosseau, S Kluge, A Kalenka, M Bachmann, L Toepfer, H Wrigge, F Redaelli, C Vetter, and M Wysocki.
- Dipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italia - gattinon@policlinico.mi.it.
- Minerva Anestesiol. 2014 Sep 1; 80 (9): 1046-57.
AbstractWe wish to report here a practical approach to an acute respiratory distress syndrome (ARDS) patient as devised by a group of intensivists with different expertise. The referral scenario is an intensive care unit of a Community Hospital with limited technology, where a young doctor, alone, must deal with this complicate syndrome during the night. The knowledge of pulse oximetry at room air and at 100% oxygen allows to estimate the PaO2 and the cause of hypoxemia, shunt vs. VA/Q maldistribution. The ARDS severity (mild [200

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Friday night ventilation a safety starting tool kit for mechanically ventilated patients.

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