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 +37  upvote downvote
submitted by โˆ—soph(84)
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you need to know diff bt negative pressure ventilation (which is normal ventilation) and positive presssure ventilation (which is mechanical ventilation). In negative pressrue ventilation the diaphragm contracts making a - intrapleural pressure which allows alveoli to expand. in positive ventilation (the pt diaphragm is not contracting thus not expanding chest cavitiy and not creating the - pressure) the machine is creating positive pressure inside alveoli so so alveoli expands. :)

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jbc5356  The smiley face got to me more than it should have. Preciate you. +7



 +7  upvote downvote
submitted by โˆ—avicenna(12)
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This is a good explanation video https://www.youtube.com/watch?v=ScoSEeZJE08

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meja2  Great video! +
sd22  @avicenna great username +



 +5  upvote downvote
submitted by โˆ—lukin4answer(11)
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During normal inspiration, alveoli starts from FRC(0mmH2O) to -1 mmh2O; this NEGATIVE pressure sucks air in. In PPV, the machine is pushing air making person do "inspiration" but now alveolar pressure is POSITIVE. & then expiration occurs passively (by elastic recoil). PEEP is an additional VERSION of PPV. Here, we do PPV but, in expiration, after some passive recoil (END EXPIRATORY PRESSURE), the machine pushes some air. So the lung does not fully deflate and return back to FRC. That's how we stabilize the small alveoli from getting collapsed after every PPV. REMEMBER, in PEEP, lung NEVER GOES BACK TO FRC. So, Alveolar pressure will ALWAYS be POSITIVE. Normally IPP is -5 after EXPIRATION (END-TIDAL) and -8 after INSPIRATION. Here we are giving +10 with Ventilation. That will overcome normal END-TIDAL (-5) making END-TIDAL IPP to +5. And of course, this +5 has no chance to become even +4 because the machine will push the air during inspiration which will make IPP even more +ve.PEEP is used to Rx Hypoxemia of ARDS. The downside is, this +ve IPP decrease VR to Rt heart and also Lt heart> reducing Cardiac Output.

Here is an Awesome video that will help: https://www.youtube.com/watch?v=24gsHagkL_8

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fatboyslim  Nice video! +
realfake  wonderful video! +



 +3  upvote downvote
submitted by chasingdreams101(4)
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Can anyone explain how 10cm H20 positive PEEP leads to Peak Inspiratory PA, End Tidal PA, Peak Inspiratory Pip and End Tidal Pip all being positive?

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tea-cats-biscuits  In PEEP, bc of how mechanical ventilation works, all the inspiration part of breathing is done by the machine actively pushing air into the lungs. As a result, there is no negative pressures in the system compared to the normal lung which needs the negative inter-pleural pressure to draw air in. +28
yotsubato  " As a result, there is no negative pressures in the system compared to the normal lung which needs the negative inter-pleural pressure to draw air in. " Thats totally what threw me off. TIL +
veryhungrycaterpillar  Why would the end tidal IP not be negative though? Sorry I must be completely misunderstanding something. +
ankigravity  Alveolar pressure will ALWAYS be POSITIVE. Normally IPP is -5 after EXPIRATION (END-TIDAL) and -8 after INSPIRATION. Here we are giving +10 with Ventilation. That will overcome normal END-TIDAL (-5) making END-TIDAL IPP to +5. (Copied from another comment because it explains it pretty well; credit to u/lukin4answer) +



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submitted by 5thgencephalosporin(8)
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https://www.youtube.com/watch?v=ScoSEeZJE08

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 +0  upvote downvote
submitted by โˆ—yousif7000(12)
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imagine the patient is a balloon and were inflating him, everything will be up, there won't be any negative pressure ie suction

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rmnss96  why is the intrapleural pressure positive? isnt it always supposed to be -ve +



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