NIPPV and Community Acquired Pneumonia

Curious for the data surrounding community acquired pneumonia and the use of NIPPV?   It may surprise you.

Blog post

Design Tweaks

There have been some site design tweaks, and the discussion forum is now the Practice Forum.  It is for general practice discussion.  Members can log in to submit content in response to posts (policy & procedures), and the content will be made available to all members.   The search bar is now conveniently located in the top navigation bar.

What are you doing at the end of May?

2012 CSRT Education Conference and Trade Show

May 31^st to June 2, 2012
Westin Bayshore Hotel
Vancouver, BC

More info on the CSRT site

Lung Protective Ventilation Certificate of Attendance

A survey was sent out after the Webinar was held. If you did not receive the link to the survey please use the contact form to send me a message and I will resend you the link. Once I've received the survey response I will send out a certificate of attendance. Thank you!

Blog changes

In a day or so the Blog link will be replaced with a news or updates page, which will be the new home page. A link to the blog that I've decided to publish more content in will be found in the sidebar and will point to the site moderator. It will be a personal professional blog on my own site. This is so I can freely write about respiratory issues, articles, research, and practice, and not make them seem like they represent the CSRT in any way.

If you subscribe to this blog you can can bookmark my new blog at http://thomaspiraino.ca

Should we worry about tidal volume when plateau pressure is low?

Some clinicians may feel that tidal volume isn't really an issue when plateau pressure is at a safe level (< 30 cm H2O).  In a paper by Hager et al. published in 2005 in the AJRCCM journal data from the ARDSNet study was seperated into quartiles of plateau pressure.  It showed that higher plateau pressures had higher mortality, even with 6 ml/kg.  

Patient's with low AND high tidal volume that had plateau pressures in the 1st quartile all had plateau pressures < 30 cm H2O (99 and 100 patients respectively).  

The absolute risk reduction (ARR) was determined and showed an ARR of 9.4% would be achieved by decreasing tidal volume to 6 ml/kg from 12 ml/kg.

So does tidal volume matter when plateau pressures are within safe limits?  Yes.