Episode 10: Ventilator dyssynchrony

Bryan and Brandon discuss ventilator dyssynchrony in ICU patients, presenting a scenario of a 54-year-old male with a history of alcohol and IV drug use, admitted with severe pancreatitis and intubated for hypoxic respiratory failure. They explore various causes of patient-ventilator asynchrony, such as flow starvation and premature cycling, and suggest management strategies, including adjusting ventilator settings like flow, tidal volume, and inspiratory time. They also address the importance of identifying and managing equipment-related issues, such as tube displacement or obstruction, and introduce the mnemonic "DOPES" (Displacement, Obstruction, Pneumothorax, Equipment, Stacking) as a tool for troubleshooting crashing patients on ventilators, emphasizing the need to stabilize the patient first and considering sedation as a last resort.