PURPOSE: The physicians who write orders for BiVent (also termed “Airway Pressure Release Ventilation” or “APRV”) are pulmonologists and intensivists. Consequently, it behooves these clinicians to be conversant with this rather exotic mode of ventilation.
METHODS: We have created a Simulation Lab which employs a two-chambered lung model (Michigan Instruments Training/Test Lung), a Servo 300 ventilator (Maquet, Inc., Wayne, NJ) to simulate spontaneous cycles, and a Maquet Servo i ventilator to simulate BiVent cycles. The Servo 300 is interfaced to one chamber (the “driving chamber”) while the contralateral chamber is interfaced to the Servo i (the “driven chamber”). The former is connected to the latter by means of a metal bar.
RESULTS: We then proceeded to create a video depicting the changes in waveforms/mechanics that occur in response to various changes in settings. The user/student is required to select these changes in response to serial arterial blood gas (ABG) reports. This twenty-six-minute video is downloadable from the internet, and can be used to acquaint interns/residents/fellows/attending physicians with the BiVent mode.
CONCLUSIONS: This has proven to be valuable, owing to the fact that candidates for BiVent are encountered sporadically.
CLINICAL IMPLICATIONS: The availability of this teaching tool is useful in order to serve as a “refresher” for clinicians who might not have had occasion to apply the BiVent mode to actual patients for a protracted period.
DISCLOSURE: The following authors have nothing to disclose: Robert Demers, Manny Banderas
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