Individualized or precision medicine uses individual patient characteristics to guide and tailor medical treatment. Applying a lung-protective ventilation strategy, which is adjusted to the individual physiology and based on constant adjustment of ventilator settings to meet changing patient needs, may reduce the potential risks of VILI better than conventional therapy.
Delegates that attend this training will learn:
- Selection of the right parameter to monitor and correct interpretation of data available is crucial for a safe clinical approach to the patient who requires mechanical ventilation. An evaluation of respiratory mechanics at the bedside allows clinicians to individualize the best available treatment to the patient’s unique lung mechanics.
- Individualized approach includes scaling VT according to the size of the aerated portion of the lung (the “baby” lung) rather than predicted “healthy” lung size, may improve lung protection. A possible way to tailor tidal volume is to use the compliance of the respiratory system (CRS). Driving pressure (ΔP), as the ratio between tidal volume and static compliance, essentially estimates the mechanical distortion provided to the baby lung.
- Recruitment strategy (recruitment manoeuvre and high level of PEEP), may improve outcome only when applied in patients with a good potential for recruitability. Assessment of patient’s individual therapeutic response helps identifying patients who are likely to benefit from the recruitment manoeuvre and higher PEEP. The P/V Tool Pro represents a simple bedside tool for assessing lung recruitability and carrying out recruitment manoeuvres.
- Transpulmonary pressure (PL), calculated as the difference between the airway pressure (Paw) and the oesophageal pressure (Peso), separates the pressure delivered to the lung from the one acting on chest wall and abdomen. As PL better indicates the risk of stress applied to the lung, it can represent the safest way to titrate mechanical ventilation and recruitment manoeuvre applied.