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Fig. 2 | Critical Care

Fig. 2

From: Mechanical power of ventilation and driving pressure: two undervalued parameters for pre extracorporeal membrane oxygenation ventilation and during daily management?

Fig. 2

Individualized and normalized mechanical power-based and driving pressure-based ventilator management: Monitoring static ventilation parameter (Pinsp, PEEP and Vt) (purple gear) at least twice a day is highly recommended. If Pdriving exceeds 15 cm H2O, Vt reductions below 6 ml/kg PBW and PEEP reductions should be critically evaluated. For in-depth analysis MP should be determined (Fig. 3). While values below 7 J/min were reported to be save, values between 7 to 15 J/min are currently a matter of debate. MP is a function of its components (Vt, Pplateau, inspiratory Flow, RR and PEEP) and every single parameter should be evaluated for potential reductions (red gear) [40]. Normalization to the CT determined well ventilated lung tissue is highly recommended. If sufficient oxygenation and adequate CO2 removal is not realizable after optimization of the ventilator strategies, indication for ECMO and extracorporeal CO2 removal devices should be critically evaluated

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