{"id":10479,"date":"2020-06-15T09:31:40","date_gmt":"2020-06-15T09:31:40","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=10479"},"modified":"2020-06-15T09:31:40","modified_gmt":"2020-06-15T09:31:40","slug":"lungsim-platforma-simulare-ventilatie-mecanica","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/lungsim-platforma-simulare-ventilatie-mecanica\/","title":{"rendered":"LungSim \u2122 – platforma simulare ventilatie mecanica"},"content":{"rendered":"

LungSim \u2122<\/strong> – platforma simulare ventilatie mecanica – In fata pandemiei COVID-19 si a unui numar tot mai mare de pacienti care au nevoie de un diagnostic adecvat, simularea asistentei critice in sesiuni de pregatire devine tot mai necesara.
\nMulte spitalele au fost sufocate cu pacienti COVID-19 necesitand internare si ingrijire in ATI, fiind nevoie de extindere rapida cu paturi ATI si personal medical pentru ingrijirea acestor pacienti.
\nAceste nevoi au fost agravate atunci cand membrii ai personalului medical ATI au necesitat punerea in carantina.
\nPentru a ajuta in lupta impotriva COVID-19, medici de prim rang si echipa de dezvoltare software a partenerului nostru \u2013 Accurate Solutions – au lucrat continuu pentru a lansa prima platforma de instruire in ventilatia mecanica, ce poate fi utilizata de sine statator sau poate fi asociata cu simulatoare de pacient.
\nAstfel, se vor putea face pasi importanti in instruirea clinica, pentru ca medicii sa dobandeasca si sa practice rapid abilitati in ventilatia mecanica.
\nPe masura ce lupta impotriva virusului evolueaza, si in asteptarea celui de-al doilea val, vor fi lansate actualizari suplimentare ale platformei de simulare.
\nSesiuni de simulare trebuie puse rapid la dispozitia personalului medical care lucreaza in unitatile de terapie intensiva. Principalele obiective ale instruirii sunt imbunatatirea cunostintelor, nivelul de confort al participantilor, si siguranta pacientului.
\nLungSim \u2122<\/strong> permite utilizatorului sa se instruiasca in utilizarea unui aparat de ventilatie mecanica, fara a fi nevoie sa detina sau sa cumpere unul!
\nLungSim \u2122<\/strong> este un simulator de ventilatie mecanica unic si imersiv.
\nAcest software permite utilizatorului sa inteleaga mecanisme respiratorii si, datorita modului de simulare, sa creeze scenarii de simulare avansate pentru mai multe cazuri de boli pulmonare sau insuficiente respiratorii acute.
\nLungSim \u2122<\/strong> incorporeaza modificarea \/ alterarea semnelor vitale, parametrii ventilatiei si multe alte caracteristici.
\nCursantul dezvolta capacitatea de a interpreta datele aparatului de ventilatie mecanica, de a formula diagnostice si de a adapta tratamente in cazul patologiilor. Mai mult, permite instructorilor sa simuleze mai multe afectiuni ale pacientului, de exemplu, boli pulmonare obstructive cronice sau sindroame de detresa respiratorie severa prin simpla schimbare a parametrilor si a valorilor aparatului de ventilatie mecanica.
\nLungSim \u2122<\/strong> este compus dintr-o interfata de invatare realista cu comenzi integrate care simuleaza un aparat de ventilatie mecanica real.
\nInstructorul poate afisa interfata cursantului sau pe PC-uri, tablete, smartphone-uri conectate prin retea, sprijinind utilizarea LungSim \u2122 in timpul scenariilor avansate de simulare.<\/p>\n

LungSim \u2122<\/strong> ca statie de lucru pentru un cursant, contine:
\n\u2022 USB stick cu software LungSim care include:
\n\u2713 Interfata realista de utilizator
\n\u2713 Interfata pentru instructor usor de utilizat, accesibila de pe orice PC, tableta, smartphone, conectate printr-o retea pentru a asigura utilizarea LungSim in timpul scenariilor avansate de simulare
\n\u2713 Licenta software
\n\u2713 Manual de utilizare
\n\u2022 Laptop<\/p>\n

Capacitatea sistemului
\nInterfata cursantului poate fi impartita in sase parti principale:
\n\u2022 info – in partea superioara a ecranului, bara de informatii contine mesaje de alarma, informatii despre pacient, data si ora.
\n\u2022 forme de unda – in partea centrala a ecranului, formele de unda sunt afisate continuu si actualizate de un cursor in miscare.
\nCursantul poate sa modifice curba afisata facand clic pe numele sau (coltul din stanga sus al casetei in care este afisata forma de unda) si selectand o alta curba din lista. Numarul de forme de unda afisate in acelasi timp poate fi schimbat din meniul \u201eViews\u201d.
\n\u2022 parametri – in partea dreapta a ecranului parametri corelati formelor de unda sunt afisati si actualizati in functie de curbe.
\nCursantul poate schimba parametrul afisat facand clic pe numele sau (coltul din stanga sus a casetei de parametri) si selectand alt parametru din lista.
\n\u2022 setari – in partea de jos a ecranului, cursantul gaseste setarile care descriu modalitatea de ventilatie curenta, selectand si modificand comportamentul ventilatorului.
\n\u2022 meniuri – in partea stanga a ecranului sunt butoane pentru mai multe submeniuri si anume:
\n\u2713 in curs de dezvoltare pana la sfasitul anului 2020: schimbarea modalitatilor de ventilatie dintre modalitati controlate (controlul volumului, controlul presiunii) sau asistata (suport de presiune, SIMV, BIBAP, EDI);
\n\u2713 modificarea configuratiei ventilatorului in trei , patru , cinci trasee de dispunere sau aspect de bucle;
\n\u2713 configurarea limitelor de alarma pentru parametri;
\n\u2713 efectuarea manevrelor, cum ar fi retinerea inspiratiei si expiratiei (inspiration and expiration hold) si efectuarea masuratorilor aferente.
\n\u2022 instrumente – pot fi accesate din butonul \u201ehamburger\u201d din dreapta sus. Acestea permit utilizatorului urmatoarele:
\n* efectuarea capturilor de ecran
\n* gestionarea (import, export, redare) configuratiilor de aspect;
\n* importul unui caz de presiune esofagiana. Parametrul de presiune esofagiana are un rol important in modul de ventilatie cu presiune si cu aceasta optiune puteti incarca propriul caz de presiune esofagiana direct dintr-un fisier Excel.
\nO presiune esofagiana consistenta este formata din doua\u00a0 coloane: in prima trebuie sa specificati momentul; in a doua coloana trebuie sa specificati valoarea presiunii esofagiene.
\n* exportul fisierelor de tip csv ale curbelor, parametrilor si setarilor afisate
\n* configurarea sincronizarii cu un simulator de pacient;
\n* personalizarea preferintelor
\n* vizualizarea informatiilor despre platforma de simulare<\/p>\n

Interfata instructorului<\/strong>
\nInterfata instructorului este interactiva si receptiva, si permite acestuia sa simuleze scenarii diferite, prin variatia parametrilor care caracterizeaza starea pacientului.
\nInterfata instructorului poate fi afisata de orice browser instalat in acelasi PC in care ruleaza LungSim, dar poate fi accesata si de pe un alt PC, smartphone sau tableta conectate in aceeasi retea, folosind adresa URL furnizata de aplicatia LungSim.
\nInterfata instructorului este formata din patru sectiuni:
\n\u2022 pacient – imaginea pacientului este interactiva si componentele sale (cai aeriene, torace, plamani, diafragma, corp) se pot selecta pentru a ajusta parametrii pacientului. Fiecare componenta este de asemenea evidentiata atunci cand un parametru este editat direct din lista de parametri de intrare
\n\u2022 parametri de intrare \u2013 Toti parametri care caracterizeaza starea pacientului virtual, sunt listati (enumerati) aici.Instructorul poate face clic pe fiecare parametru pentru a-l edita.
\n\u2022 parametri avansati – aceasta sectiune consta dintr-o subcategorie de parametri de intrare, pentru configuratii avansate, cum ar fi pierderi de flux expirator (expiratory flow losses) sau presiune inspiratorie delta (inspiratory hold delta P1-P2).
\nParametri non-liniari de conformitate: in sectiunea de parametri avansati puteti gasi, de asemenea, optiunea permite respectarea parametrilor (compliantei) non-liniari
\nIn aceasta sectiune este posibil sa se modifice cei patru parametri (A, B, C, D) care determina valoarea si tendinta non-liniara a compliantei – descrise in graficul sigmoid P-V si in graficul de complianta situat in
\npartea de jos a sectiunii
\n\u2022 parametri de iesire – toti parametrii care descriu raspunsul pacientului virtual la ventilatia mecanica, sunt listati (enumerati) aici . Acesti parametri sunt read-only.
\nInterfata instructorului permite acestuia sa salveze configurarea parametrilor de incarcare pentru a crea diferite cazuri.
\nSe pot efectua masuratori pentru amplitudinea sau lungimea de unda a unei anumite curbe:
\n\u2713 masurare orizontala
\n\u2713 masurare verticala
\n\u2713 stergerea adnotarii
\nSincronizare intrare \/ iesire cu simulatoarele de pacient LungSim poate fi conectat cu simulatoarele de pacient Gaumard Scientific prin intermediul software-ului UNI, permitand sincronizarea intre
\nsemnele vitale simulate de manechin si parametrii simulatorului LungSim.<\/p>\n

SCENARIU COVID-19<\/strong><\/p>\n

\nCaz clinic : Pacient suspect de COVID-19
\nAutori: – Prof. V. Marco Ranieri, Dr.ssa Irene Cavalli si Dr. Tommaso Tonetti – Anesthesia and Intensive Care Medicine, Alma Mater Studiorum University of Bologna Policlinico di Sant\u2019Orsola, Bologna, Italy
\nPasul 0: Introducere \u2013 Pacientul ajunge in unitatea de primiri urgente – UPU
\n\u2022 Prenume: Max
\n\u2022 Nume: Red
\n\u2022 Sex: Male
\n\u2022 Varsta: 63
\n\u2022 Inaltime: 175 cm
\n\u2022 Greutate: 92 Kg
\n\u2022 Indice de Masa Corporala: 30,04 Kg\/m2
\n\u2022 PBW: 70 Kg (Barbat=50+0.91x(inaltime in cm-152.4); Femeie= 45.5+0.91x(inaltime in cm-152.4))<\/p>\n

Prezentare Clinica
\n\u2022 Prezinta febra de 4 zile (>38 \u25e6C), tuse uscata, dureri musculare si oboseala
\n\u2022 Dispnee<\/p>\n

Semne Vitale
\n\u2022 Frecventa respiratiei spontane: 29 c\/min
\n\u2022 Timpul inspirator: 30%
\n\u2022 Saturatie O2: 88% (FiO2% 21%)
\n\u2022 EtCO2: 27 mmHg
\n\u2022 Presiune Arteriala: 125\/80 mmHg
\n\u2022 PaO2\/FiO2 (P\/F ratio): 85<\/p>\n

Patologii associate (Comorbiditati)
\n\u2022 Hipertensiune
\n\u2022 Diabet<\/p>\n

Examinari
\n-Scanare CT : opacitate in sticla mata dispusa periferic, bilateral asociata cu septuri subtiri intralobulare si interlobulare (crazy-paving pattern)
\n-Ecografie Pulmonara:<\/p>\n

Spatiul intercostal IV medio-clavicular drept: pneumonie interstitiala alveolara asociata Covid-19
\nSpatiul intercostal V drept pe linia medio-axilara: pneumonie interstitiala alveolara asociata Covid-19<\/p>\n

Nota\/Comentariu:
\nPacient cu respiratie spontana in UPU<\/p>\n

Pasul 1: Ventilatie mecanica invaziva \u2013 intrarea in
\nTerapie Intensiva<\/p>\n

Situatie clinica\/evolutie
\n\u2022 PaO2\/FiO2 (P\/F ratio): 100<\/p>\n

Set Parametrii Pacient
\n\u2022 Right Lung Compliance: 67 ml\/cmH2O
\n\u2022 Left Lung Compliance: 67 ml\/cmH2O
\n\u2022 Torax Compliance: 98 ml\/cmH2O
\n\u2022 Right Lung Resistance: 3 cmH2O\/L\/sec
\n\u2022 Left Lung Resistance: 3 cmH2O\/L\/sec
\n\u2022 Additional Expiratory Resistance: 4.8 cmH2O\/L\/sec
\n\u2022 Spontaneous Respiratory Rate: 0 b\/min
\n\u2022 Spontaneous Inspiratory Percentage: 33 %
\n\u2022 Spontaneous Tidal Volume: 0 ml
\n\u2022 Respiratory Muscle Effort: 0 cmH2O
\n\u2022 Intrinsic PEEP: 0.5 cmH2O
\n\u2022 Esophageal Pressure: N\/A
\n\u2022 Expiratory Flow Losses: 0 ml\/s
\n\u2022 Inspiratory Hold Delta P1-P2: 1 cmH2O<\/p>\n

Set Parametrii de Iesire
\n\u2022 Respiratory Rate (b\/min): same value as set on the ventilator
\n\u2022 Inpiration Time (%): same value as set on the ventilator
\n\u2022 O2 saturation: 92 %
\n\u2022 EtCO2: 28 mmHg
\n\u2022 Arterial Pressure: 105\/60 mmHg<\/p>\n

Volume Control
\n\u2022 Tidal Vol. (ml) Tidal Volume: 420 ml
\n\u2022 PEEP (cmH2O) Positive End-Expiratory Pressure: 10 cmH2O
\n\u2022 Resp. Rate (b\/min) Respiratory Rate: 18 b\/min
\n\u2022 Ti (%) Inspiration Time: 33 %
\n\u2022 T insp. rise (%) Inspiration Rise Time: 10 %
\n\u2022 T pause (%) Pause Time: 15 %
\n\u2022 O2 conc. (%) O2 Concentration: 80 %
\nNota\/Comentariu
\nPacient ventilat mecanic si intubat la intrarea in Terapie Intensiva<\/p>\n

Pasul 2: 24 ore dupa ventilatia mecanica invaziva \u2013 pacientul in continuare pe sectia de Terapie Intensiva<\/p>\n

Situatie clinica\/evolutie
\n\u2022 PaO2\/FiO2 (P\/F ratio): 190<\/p>\n

Examinari
\n-Scanare CT : opacitate in sticla mata dispusa periferic, bilateral
\nasociata cu septuri subtiri intralobulare si interlobulare (crazy-paving pattern)
\n-Ecografie Pulmonara:<\/p>\n

Spatiul intercostal II medio-clavicular drept: pneumonie interstitiala alveolara asociata Covid-19
\nSpatiul intercostal III drept pe linia medio-axilara: pneumonie interstitiala alveolara asociata Covid-19
\nSpatiul intercostal II medio-clavicular stang: pneumonie interstitiala alveolara asociata Covid-19
\nSpatiul intercostal III medio-clavicular stang: pneumonie interstitiala alveolara asociata Covid-19, plaman alb (white lung)<\/p>\n

Set Parametrii Pacient
\n\u2022 Right Lung Compliance: 70 ml\/cmH2O
\n\u2022 Left Lung Compliance: 70 ml\/cmH2O
\n\u2022 Torax Compliance: 102 ml\/cmH2O
\n\u2022 Right Lung Resistance: 2.5 cmH2O\/L\/sec
\n\u2022 Left Lung Resistance: 2.5 cmH2O\/L\/sec
\n\u2022 Additional Expiratory Resistance: 4 cmH2O\/L\/sec
\n\u2022 Spontaneous Respiratory Rate: 0 b\/min
\n\u2022 Spontaneous Inspiratory Percentage: 33 %
\n\u2022 Spontaneous Tidal Volume: 0 ml
\n\u2022 Respiratory Muscle Effort: 0 cmH2O
\n\u2022 Intrinsic PEEP: 1 cmH2O
\n\u2022 Esophageal Pressure: N\/A
\n\u2022 Expiratory Flow Losses: 0 ml\/s
\n\u2022 Inspiratory Hold Delta P1-P2: 1.5 cmH2O<\/p>\n

Set Parametrii de Iesire
\n\u2022 Respiratory Rate (b\/min): same value as set on the ventilator
\n\u2022 Inpiration Time (%): same value as set on the ventilator
\n\u2022 O2 saturation: 97 %
\n\u2022 EtCO2: 28 mmHg
\n\u2022 Arterial Pressure: 110\/65 mmHg<\/p>\n

Volume Control
\n\u2022 Tidal Vol. (ml) Tidal Volume: 420 ml
\n\u2022 PEEP (cmH2O) Positive End-Expiratory Pressure: 14 cmH2O
\n\u2022 Resp. Rate (b\/min) Respiratory Rate: 20 b\/min
\n\u2022 Ti (%) Inspiration Time: 33 %
\n\u2022 T insp. rise (%) Inspiration Rise Time: 10 %
\n\u2022 T pause (%) Pause Time: 17 %
\n\u2022 O2 conc. (%) O2 Concentration: 70 %
\nNota\/Comentariu
\nPacient in pozitie de pronatie (cel putin 16 ore pe zi), cu schimburi gazoase si mecanisme respiratorii usor imbunatatite<\/p>\n

Pasul 3A: Ziua 15 dupa ventilatia mecanica invaziva \u2013
\nPacient ameliorat, dar in continuare internat la Terapie Intensiva<\/p>\n

Situatie clinica\/evolutie
\n\u2022 PaO2\/FiO2: 240<\/p>\n

Examinari
\n-Scanare CT: opacitatile anterioare se disipeaza in opacitati in sticla mata si opacitati liniare neregulate
\n-Ecografie Pulmonara:
\nSpatiul intercostal IV medio-clavicular drept: pneumonie interstitiala alveolara asociata Covid-19<\/p>\n

Set Parametrii Pacient
\n\u2022 Right Lung Compliance: 85 ml\/cmH2O
\n\u2022 Left Lung Compliance: 85 ml\/cmH2O
\n\u2022 Torax Compliance: 125 ml\/cmH2O
\n\u2022 Right Lung Resistance: 3 cmH2O\/L\/sec
\n\u2022 Left Lung Resistance: 3 cmH2O\/L\/sec
\n\u2022 Additional Expiratory Resistance: 6 cmH2O\/L\/sec
\n\u2022 Spontaneous Respiratory Rate: 24 b\/min
\n\u2022 Spontaneous Inspiratory Percentage: 33 %
\n\u2022 Spontaneous Tidal Volume: 200 ml
\n\u2022 Respiratory Muscle Effort: 8 cmH2O
\n\u2022 Intrinsic PEEP: 1 cmH2O
\n\u2022 Esophageal Pressure: N\/A
\n\u2022 Expiratory Flow Losses: 0 ml\/s
\n\u2022 Inspiratory Hold Delta P1-P2: 1.5 cmH2O<\/p>\n

Set Parametrii de Iesire
\n\u2022 Respiratory Rate (b\/min): same value as set on the ventilator
\n\u2022 Inpiration Time (%): same value as set on the ventilator
\n\u2022 O2 saturation: 98 %
\n\u2022 EtCO2: 32 mmHg
\n\u2022 Arterial Pressure: 115\/75 mmHg<\/p>\n

Pressure Support
\n\u2022 PS above PEEP (cmH2O) Pressure Level Above PEEP: 10 cmH2O
\n\u2022 PEEP (cmH2O) Positive End-Expiratory Pressure: 8 cmH2O
\n\u2022 T insp. rise (%) Inspiration Rise Time: 10 %
\n\u2022 O2 conc. (%) O2 Concentration: 50 %
\n\u2022 Trigger (L\/min) Trigger: 2 L\/min
\n\u2022 End insp. (%): 20 %
\n\u2022 Backup Vent. P above PEEP (cmH2O): 10 cmH2O
\n\u2022 Backup Vent. Resp. Rate (b\/min): 20 b\/min
\n\u2022 Backup Vent. Ti (%): 33 %
\nNota\/Comentariu
\nAmeliorarea respiratorie, pacientul respira spontan cu ajutorul ventilatiei cu suport in presiune (PSV), dar cu efort respirator mare.<\/p>\n

Pasul 3B: Ziua 15 dupa ventilatia mecanica invaziva \u2013 starea pacientului nu se amelioreaza si se afla in
\ncontinuare pe sectia de Terapie Intensiva<\/p>\n

Situatie clinica\/evolutie
\n\u2022 PaO2\/FiO2: 95<\/p>\n

Examinari
\n-Scanare CT leziuni pulmonare bilaterale, cu consolidari pulmonare dense si largi si efuziuni pleurale bilaterale.
\n-Ecografie Pulmonara:
\nSpatiul intercostal III stang pe linia medio-axilara: pneumonie interstitiala alveolara aociata Covid-19 si consolidari subpleurale
\nSpatiul intercostal V stang pe linia medio-axilara: pneumonie interstitiala alveolara aspciata Covid-19 si consolidari subpleurale
\nSpatiul intercostal V stang pe linia medio-axilara: linia pleurala intrerupta, multiple linii B macrogranulare si consolidari subpleurale<\/p>\n

Set Parametrii Pacient
\n\u2022 Right Lung Compliance: 53 ml\/cmH2O
\n\u2022 Left Lung Compliance: 53 ml\/cmH2O
\n\u2022 Torax Compliance: 82 ml\/cmH2O
\n\u2022 Right Lung Resistance: 3.4 cmH2O\/L\/sec
\n\u2022 Left Lung Resistance: 3.4 cmH2O\/L\/sec
\n\u2022 Additional Expiratory Resistance: 5.2 cmH2O\/L\/sec
\n\u2022 Spontaneous Respiratory Rate: 0 b\/min
\n\u2022 Spontaneous Inspiratory Percentage: 0 %
\n\u2022 Spontaneous Tidal Volume: 0 ml
\n\u2022 Respiratory Muscle Effort: 0 cmH2O
\n\u2022 Intrinsic PEEP: 1 cmH2O
\n\u2022 Esophageal Pressure: N\/A
\n\u2022 Expiratory Flow Losses: 0 ml\/s
\n\u2022 Inspiratory Hold Delta P1-P2: 1.5 cmH2O<\/p>\n

Set Parametrii de Iesire
\n\u2022 Respiratory Rate (b\/min): same value as set on the ventilator
\n\u2022 Inpiration Time (%): same value as set on the ventilator
\n\u2022 O2 saturation: 93 %
\n\u2022 EtCO2: 35 mmHg
\n\u2022 Arterial Pressure: 95\/60 mmHg<\/p>\n

Volume Control
\n\u2022 Tidal Vol. (ml) Tidal Volume: 480 ml
\n\u2022 PEEP (cmH2O) Positive End-Expiratory Pressure: 16 cmH2O
\n\u2022 Resp. Rate (b\/min) Respiratory Rate: 22 b\/min
\n\u2022 Ti (%) Inspiration Time: 33 %
\n\u2022 T insp. rise (%) Inspiration Rise Time: 10 %
\n\u2022 T pause (%) Pause Time: 18 %
\n\u2022 O2 conc. (%) O2 Concentration: 90 %
\nNota\/Comentariu
\nAlternativa la 3a, acest pacient nu se amelioreaza si ventilatia se inrautateste (pacient tipic cu mortalitate ridicata in Terapie Intensiva)<\/p>\n

Pasul 4: Ziua 21 dupa ventilatia mecanica invaziva
\nSituatie clinica\/evolutie
\n\u2022 PaO2\/FiO2: 310
\nExaminari
\n-Scanare CT: opacitatile anterioare se disipeaza in opacitati in sticla mata si opacitati liniare neregulate<\/p>\n

Set Parametrii Pacient
\n\u2022 Right Lung Compliance: 100 ml\/cmH2O
\n\u2022 Left Lung Compliance: 100 ml\/cmH2O
\n\u2022 Torax Compliance: 140 ml\/cmH2O
\n\u2022 Right Lung Resistance: 2 cmH2O\/L\/sec
\n\u2022 Left Lung Resistance: 2 cmH2O\/L\/sec
\n\u2022 Additional Expiratory Resistance: 4.5 cmH2O\/L\/sec
\n\u2022 Spontaneous Respiratory Rate: 15 b\/min
\n\u2022 Spontaneous Inspiratory Percentage: 33 %
\n\u2022 Spontaneous Tidal Volume: 200 ml
\n\u2022 Respiratory Muscle Effort: 3 cmH2O
\n\u2022 Intrinsic PEEP: 0 cmH2O
\n\u2022 Esophageal Pressure: N\/A
\n\u2022 Expiratory Flow Losses: 0 ml\/s
\n\u2022 Inspiratory Hold Delta P1-P2: 0 cmH2O<\/p>\n

Set Parametrii de Iesire
\n\u2022 Respiratory Rate (b\/min): same value as set on the ventilator
\n\u2022 Inpiration Time (%): same value as set on the ventilator
\n\u2022 O2 saturation: 99 %
\n\u2022 EtCO2: 35 mmHg
\n\u2022 Arterial Pressure: 120\/70 mmHg<\/p>\n

Pressure Support
\n\u2022 PS above PEEP (cmH2O) Pressure Level Above PEEP: 8 cmH2O
\n\u2022 PEEP (cmH2O) Positive End-Expiratory Pressure: 5 cmH2O
\n\u2022 T insp. rise (%) Inspiration Rise Time: 0 %
\n\u2022 O2 conc. (%) O2 Concentration: 30 %
\n\u2022 Trigger (L\/min) Trigger: 2 L\/min
\n\u2022 End insp. (%): 30 %
\n\u2022 Backup Vent. P above PEEP (cmH2O): 8 cmH2O
\n\u2022 Backup Vent. Resp. Rate (b\/min): 14 b\/min
\n\u2022 Backup Vent. Ti (%): 33 %<\/p>\n

Concluzii<\/strong>
\nPunctele cheie ale sindromului de detresa respiratorie acuta <\/strong>cauzat de Covid 19 sunt rezumate astfel :<\/strong>
\n1. Pacientii cu sindrom de detresa respiratorie acuta (ARDS) se <\/strong>caracterizeaza prin complianta mare a sistemului respirator, <\/strong>nefiind necesar un nivel inalt al PEEP (presiunea pozitiva de la <\/strong>sfarsitul expirului).<\/strong>
\n2. Inceperea cat mai curand a pozitiei de pronatie cu cicluri de cel <\/strong>putin 16 ore; aceasta poate imbunatati mecanismele de oxigenare <\/strong>si respiratorii ca rezultat al imbunatatirii compliantei pulmonare.<\/strong>
\n3. Rezultatele CT aratand efuziuni pleurale si consolidari <\/strong>pulmonare reprezinta un slab indicator de prognostic pentru <\/strong>pacientii cu sindrom de detresa respiratorie acuta (ARDS) de <\/strong>etiologie Covid 19. Aceste alterari sunt asociate cu mecanisme <\/strong>respiratorii si de oxigenare slabe.<\/strong><\/p>\n

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LungSim \u2122 – platforma simulare ventilatie mecanica – In fata pandemiei COVID-19 si a unui numar tot mai mare de pacienti care au nevoie de un diagnostic adecvat, simularea asistentei […]<\/p>\n","protected":false},"author":6,"featured_media":10328,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[278,1],"tags":[667],"class_list":["post-10479","post","type-post","status-publish","format-standard","has-post-thumbnail","category-ati","category-stiri-noutati","tag-lungsim"],"yoast_head":"\nLungSim \u2122 - platforma simulare ventilatie mecanica - Jurmed - Medici<\/title>\n<meta name=\"description\" content=\"LungSim COVID-19 platforma simulare ventilatie mecanica\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/jurmed.ro\/medici\/lungsim-platforma-simulare-ventilatie-mecanica\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LungSim \u2122 - 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