Eduardo Mireles-Cabodevila @emireles_c Twitter profile

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Eduardo Mireles-Cabodevila

@emireles_c

5 months

Today at 2 PM, SEVA VentRounds. Password for link: breath

Eduardo Mireles-Cabodevila

@emireles_c

7 months

🚀 Dive deeper into mechanical ventilation with #SEVAVentRounds ! Join us for enriching 30-min discussions. LINK: Learn, discuss, and grow together! @CCF_PCCM @msiuba @_MSAMEED @Thind888 @OfVentilation @Vent_Busters @DrMiguelIbarra1

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

We described a step by step method to read ventilator waveforms. Just what we do at VentRounds! So much to learn ahead. @msiuba @RobChatburn @CCF_PCCM @aarc_tweets @curso_vm @JmNunezSilveira @JHUPCCMFellows @some4mv @respcare @MegriMohammed @Thind888

A Taxonomy for Patient-Ventilator Interactions and a Method to Read Ventilator Waveforms - PubMed

Mechanical ventilators display detailed waveforms which contain a wealth of clinically relevant information. Although much has been written about interpretation of waveforms and patient-ventilator...

pubmed.ncbi.nlm.nih.gov

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Midnight tweetorial. Differentiating effort from air trapping in the expiratory phase of waveforms can be challenging. Here is some general guidance and examples. @some4mv @OrlandoRPN @msiuba @Thind888 @CCF_PCCM @curso_vm @ventilacionmeca @DrMiguelIbarra1 @MegriMohammed @kvenere

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Work shifting, flow asynchrony, flow starvation. So many terms... To highlight this patient-ventilator discordance here is a very severe case and tweetorial. @msiuba @RobChatburn @siddharth_dugar @MonaresTI @DocMusician @CCF_PCCM @CleClinicRespir #some4mv #ventrounds

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Live VentRounds, free, lets dissect the waveforms together! #VentRounds . February 23, 2021 at 2 PM EST The link @RobChatburn @msiuba @curso_vm . @ventilacionmeca @some4mv . @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

COVID + ARDS day 16...What is the cause of this ventilator-patient discordance ?

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

You walk by the ICU, you glance at a ventilator. This is what you see going on. No alarms. Patient looks comfortable. #VentRounds @CCF_PCCM #some4mv #FOAMed @CleClinicRespir

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Good morning world. Sitting in the office working. Stopped to enjoy. #breathe

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

WOW. These were VERY challenging waveforms to read. Here are my thoughts, but expect controversy as this took me a while to decipher. #VentRounds #some4MV #MedTwitter @concernecus @RobChatburn @msiuba @aarc_tweets @donnatanner815 @CCF_PCCM @Thind888 @ArgaizR @MegriMohammed

Eduardo Mireles-Cabodevila

@emireles_c

4 years

@concernecus provided this ventilation puzzler. Look carefully, answer poll, response later today. #ventrounds #some4MV @msiuba @RobChatburn @ArgaizR @dileepraman @siddharth_dugar @aarc_tweets @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

11 months

With @RobChatburn On our way to Mexico to do the first international SEVA course at @incmnszmx ! #SEVAVentRounds @CCF_PCCM @snamendys @ArielG_RRT @PacoDardon @Mafer_garg @medpedshosp @ArgaizR @josebaltazart @RaedDweikMD @DrMiguelIbarra1

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

We are getting inducted FCCM #SCCM2023 . ⁦with good friend @AGMRRT ⁩ and partner in Respiratory Care committee!

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

The answer: Early cycling it is! How do you deal with it? #VentRounds @CCF_PCCM @CleClinicRespir #FOAMed #SoMe4MV

Eduardo Mireles-Cabodevila

@emireles_c

4 years

You walk by the ICU, you glance at a ventilator. This is what you see going on. No alarms. Patient looks comfortable. #VentRounds @CCF_PCCM #some4mv #FOAMed @CleClinicRespir

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

A high quality guideline. Respiratory Management of Patients With Neuromuscular Weakness: An Ame...

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Had to stop, unable to ignore. Lets discuss this and other waveforms. Join live interactive #VentRounds March 9th at 2 PM EST. It's free. link to meeting: @CCF_PCCM @curso_vm @ventilacionmeca @some4mv @CleClinicRespir @msiuba @RobChatburn @abribriesco43

Eduardo Mireles-Cabodevila

@emireles_c

4 years

Live VentRounds, free, lets dissect the waveforms together! #VentRounds . February 23, 2021 at 2 PM EST The link @RobChatburn @msiuba @curso_vm . @ventilacionmeca @some4mv . @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Patient-ventilator discordance is common, level of interpretation among ICU clinicians is unknown. Please join us in this survey . Will present answers at 7 pm EST on March 2nd. Webinar link at the end of the survey. @CCF_PCCM @msiuba @ArielG_RRT @SCCMohio

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

A little taste of tomorrow's SEVA #VentRounds . focusing on triggering problems. Free and interactive, join us May 5, at 2PM EST. Link @some4mv @curso_vm @HawraaHH @msiuba @aarc_tweets @SCCMohio @roeckler @DrivingPressure @COMMEC_Of @CCF_PCCM @accpchest

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Sitting calmly in the ICU, you are called to give a verdict on this waveform. What is it? and what will you do? @CCF_PCCM @RobChatburn #SoMe4MV @aarc_tweets @ArgaizR @msiuba @mossy_rolling #VentRounds @Thind888

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

The Verdict: The End Inspiratory Pressure Rise due to muscle relaxation is a common finding in PC-CSVs . See explanation below. Great editorial by Dr. Magdy Younes #VentRounds #SoMe4MV @MonaresTI @DocMusician @msiuba @ArgaizR @RobChatburn @CCF_PCCM

Eduardo Mireles-Cabodevila

@emireles_c

4 years

Sitting calmly in the ICU, you are called to give a verdict on this waveform. What is it? and what will you do? @CCF_PCCM @RobChatburn #SoMe4MV @aarc_tweets @ArgaizR @msiuba @mossy_rolling #VentRounds @Thind888

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Give it a shot, answers tomorrow at SEVA VentRounds, the first one of 2022. 2 PM EST Link, free, below: @CCF_PCCM @JHUPCCMFellows @YalePCCSM @msiuba @CleClinicLungs @aarc_tweets @iceman_ex @JmNunezSilveira @curso_vm @HawraaHH @be_an_rt @MSRC_TexasState

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

A open access primer on esophageal pressure measurements. Still lots to learn! @msiuba @Thind888 @ArgaizR @CCF_PCCM @SimonMuchaMD @AbhiDuggalMD @RespiratorySCCM @SCCMohio @MegriMohammed @OfVentilation @aarc_tweets @AGMRRT @HawraaHH @DrMiguelIbarra1

Esophageal Pressure Measurement: A Primer

Over the last decade, the literature exploring clinical applications for esophageal manometry in critically ill patients has increased. New mechanical ventilators and bedside monitors allow measure...

rc.rcjournal.com

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Here is the answer we discussed at SEVA VentRounds. The key finding is discordant loads. 😳See attached! Will soon add link to video discussion. @CCF_PCCM @msiuba @OrlandoRPN @DrMiguelIbarra1 @DocMusician @ArielG_RRT @Vent_Busters @OfVentilation @SCCMohio @RespiratorySCCM

Eduardo Mireles-Cabodevila

@emireles_c

2 years

TODAY 2 PM EST SEVA VentRounds. We discuss this case, rare but lethal, can you guess what is the cause? What is the key clue? FREE Link @CCF_PCCM @msiuba @DrMiguelIbarra1 @OrlandoRPN @ArielG_RRT @RespiratorySCCM @SCCMohio @Vent_Busters

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

After a long-needed holiday, VentRounds are back. Today 2 pm New York time. Free link: Today's cases should be fun. @DocMusician @msiuba @AGMRRT @CCF_PCCM @EmoryPCCM @MegriMohammed @ukypccm @UCRCriticalCare @ArielG_RRT @JmNunezSilveira @ventilacionmeca

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Now available: Updated SEVA Vent Mode App: has the taxonomy for each mode, ventilators that have same modes, and a dictionary for ventilation terms. FREE @CCF_PCCM @msiuba @OrlandoRPN @ArielG_RRT @aarc_tweets @ClevelandClinic

‎Ventilator Mode Map

‎This app is designed to implement the taxonomy (classification system) for modes of mechanical ventilation described by Chatburn et al (Respir Care 2014;59(11):1747-1763). It has photographs, model...

apps.apple.com

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

This is a classic Back to Basics. Image by @DrSateeshPCCM . Review and we can discuss live tomorrow @ SEVA VentRounds at 2 pm EST here is the link: @CCF_PCCM @some4mv @msiuba @DocMusician @JmNunezSilveira @ventilacionmeca @DrivingPressure @gretchemaben

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Two CLINICAL questions: 1) What is your clinical definition of shock? (How you identify it?) 2) when is shock clinically resolved? @AndromedaShock @msiuba @OrlandoRPN @siddharth_dugar @CCF_PCCM @Thind888 @MonaresTI @ogi_gajic @SCCMohio @KapoorA_CC @SethRBauer @AbhiDuggalMD

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Lots of action going on in this waveform. Thank you for sharing @himanshu_deshwa . Trigger delay, trigger work and some failed triggers are the answer. #VentRounds @msiuba #some4mv

Himanshu Deshwal

@himanshu_deshwa

4 years

@emireles_c @msiuba #ventrounds can you assist in this form of asynchrony? Big fan of your vent rounds.

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Web page for SEVA Vent Rounds. Has prior recorded sessions and link to the free live rounds (next April 6, at 2 PM EST) @msiuba @curso_vm @SebastianRLL @donnatanner815 @MegriMohammed @some4mv @aarc_tweets 😀 @DrivingPressure @MonaresTI @SCCMohio @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

TODAY 2 PM EST SEVA VentRounds. We discuss this case, rare but lethal, can you guess what is the cause? What is the key clue? FREE Link @CCF_PCCM @msiuba @DrMiguelIbarra1 @OrlandoRPN @ArielG_RRT @RespiratorySCCM @SCCMohio @Vent_Busters

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

After SEVA #VentRounds , here is a summary slide of this triggering nightmare. @some4mv @MegriMohammed @msiuba @curso_vm @JmNunezSilveira @SebastianRLL @abribriesco43 @COMMEC_Of @Thind888 @HawraaHH @ArgaizR @MonaresTI @CCF_PCCM Great discussion today, see you May 18 @ 2PM EST

Eduardo Mireles-Cabodevila

@emireles_c

4 years

A little taste of tomorrow's SEVA #VentRounds . focusing on triggering problems. Free and interactive, join us May 5, at 2PM EST. Link @some4mv @curso_vm @HawraaHH @msiuba @aarc_tweets @SCCMohio @roeckler @DrivingPressure @COMMEC_Of @CCF_PCCM @accpchest

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Dual targeting hits again. This is a "clandestine" targeting scheme, as most of the time, we do not know it is active or even that it exists on the ventilator. @ElliottMillerMD @Sam_Brusca @RobChatburn @curso_vm @OrlandoRPN @Thind888 @DrivingPressure @com543 @some4mv @CCF_PCCM

Elliott Miller

@ElliottMillerMD

3 years

Does anyone have ideas about what happened here? Note, it was happening every other breath. I have some thoughts, but would love to hear some from the community. #CardioTwitter #criticalcare @carlosalviar @WApplefeld @NitinSeam @snigdhajain89 @emireles_c

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Awesome session #CHEST2022 on shock hemodynamic assessment with @msiuba @siddharth_dugar @katiewiskar @MaxHockstein the message: have a method, know your tools, use context! @CCF_PCCM @accpchest @RaedDweikMD @AnnGageMD @KapoorA_CC @angelcozyataco @NealChaisson

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

How do you deal with this?

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

Here is the answer! Work shifting indeed. Great job @krveshi @msiuba @siddharth_dugar @SGBraunthal @Thind888 #VentRounds #MedTwitter A deeper explanation at

Eduardo Mireles-Cabodevila

@emireles_c

5 years

COVID 19, 7 days on ventilator. What is happening here in terms of patient-ventilator discordance? #ventRounds #MedTwitter @msiuba @donnatanner815 @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Visiting the ICU @ Angeles Lomas Hospital Mexico I could “hear” silence, No alarms 🤫Their practice: ANY alarm is immediately attended. Thus no alarm fatigue! #cultureshift #delirium @VazquezMathieu @WesElyMD @msiuba @AbhiDuggalMD @CCF_PCCM @AnitaJReddy @Mibiehl @theloneskillet

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

#ACC2023 Cardiac Critical Care simulation center is an awesome use of simulation to engage all in best practices! Thank you simulation committee @ACCinTouch for great event. @carlosalviar @PennyRampersad @NealChaisson @ClevelandClinic @AnnGageMD @RanLeeMD @AndrewHigginsMD

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Buttons that change modes without telling. 🤯😱😳Here is a brief tutorial and the link to SEVA VentRounds. @CCF_PCCM @msiuba @Thind888 @siddharth_dugar @OrlandoRPN @MegriMohammed @SCCMohio @RespiratorySCCM @abribriesco43 @ventilacionmeca @JmNunezSilveira @nickmmark @aarc_tweets

Eduardo Mireles-Cabodevila

@emireles_c

2 years

VentRounds Tomorrow at 2 PM EST. Free, CRCE credits. Link: Why pressure drops at the beginning of expiration? Let's discuss tomorrow. @CCF_PCCM @JHUPCCMFellows @RespiratorySCCM @Vent_Busters @SMHCoEMV @msiuba @Thind888 @ArielG_RRT @SCCMohio @JieLiRRT

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

The best example in a patient of all the effects of Dual targeting. Live discussion today, Nov 30 at 2 PM EST (GMT-5), free SEVA #VentRounds here the link @CleClinicLungs @CCF_PCCM @msiuba @MayoPCCM @JHUPCCMFellows @some4mv @curso_vm @OrlandoRPN @rbauld

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

VentRounds Tomorrow at 2 PM EST. Free, CRCE credits. Link: Why pressure drops at the beginning of expiration? Let's discuss tomorrow. @CCF_PCCM @JHUPCCMFellows @RespiratorySCCM @Vent_Busters @SMHCoEMV @msiuba @Thind888 @ArielG_RRT @SCCMohio @JieLiRRT

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

I was called today to see this waveform. Patient looks ill but overall calm. What does the #VentRounds group think is going on? @CCF_PCCM @MonaresTI @ArgaizR @cursovm @msiuba @respresource @msiuba @Thind888 #SoMe4MV

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Eduardo Mireles-Cabodevila

@emireles_c

9 months

Just uploaded 4 new episodes of SEVA VentRounds (SVR) via @YouTube @MSRC_TexasState @AGMRRT @Vent_Busters @OfVentilation @RScheraga @RespiratorySCCM @SCCMohio @aarc_tweets @chatterJ5 @_MSAMEED @PulmPEEPs @we_vent @ArielG_RRT @CCF_PCCM @HawraaHH @msiuba

SEVA VentRounds (SVR)

SEVA VentRounds (SVR) is designed to offer live, online educational support for learning how to look at ventilator settings in order to evaluate the effectiv...

www.youtube.com

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

What is the issue here? lets discuss @ SEVA VentRounds tomorrow at 2 PM EST. live, free, all invited. link @msiuba @DrivingPressure @some4mv @CCF_PCCM @Thind888 @BasselAkbik @VashishtRishik @Donicme @CommecOficial @BrianKWalsh @MegriMohammed @kdlamb1

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

Today SEVA VentRounds at 2 PM EST. free CRCE, join us for 30 min of ventilation education. Will analyze this waveforms by @pulmtoilet LINK: … @StephMaximous @msiuba @DrMiguelIbarra1 @ArielG_RRT @snamendys @ventilacionmeca @JmNunezSilveira @CCF_PCCM

nick pulmcrit

@pulmtoilet

1 year

On arrival to the room, you note the patient appears well sedated and tolerating mechanical ventilation. After a quick exam you notice the following waveform :

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Video to Test yourself with 15 waveform questions. These were questions from a Survey we sent early this month. @JieLiRRT @AGMRRT @RespiratorySCCM @SCCMohio @CCF_PCCM @OfVentilation @ArielG_RRT @DocMusician @ventilacionmeca @aarc_tweets @Vent_Busters

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Tomorrow Tuesday March 22 at 2PM EST free SEVA VentRounds. Join and learn all together. Link a little taste here. Thoughts? @YalePCCSM @CCF_PCCM @HopkinsPCCM @msiuba @OrlandoRPN @ArielG_RRT @aravindamenon @DrMiguelIbarra1 @Thind888 @HawraaHH @ogi_gajic

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

COVID 19, 7 days on ventilator. What is happening here in terms of patient-ventilator discordance? #ventRounds #MedTwitter @msiuba @donnatanner815 @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

Incredible last day at #Mexcrit2023 with great lectures by Mitch Levy, Janice Zimmerman, Christa Schorr, Nitin Puri and @EMedCoach and a delicious “morning rounds” barbacoa with new friends. #INNSZ @roomaan89 @PacoDaFi @Roy_fig @FacmedRubi @anacloty @snamendys @PacoDaFi @ArgaizR

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

Today we ran the SEVA team training (level 4 of 6 of Vent training) with an outstanding group of fellows from PCCM/CCM/NICU/SICU @ClevelandClinic . #MedEd @ @CCF_PCCM @msiuba @NealChaisson @Sherry2517 @avantika93MD @gauravmanek5 @Thind888 @VashishtRishik @carlosalviar @_MSAMEED

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Enjoyed the work from @SimonMuchaMD @siddharth_dugar on Coagulopathy in COVID-19: Manifestations and management @CCF_PCCM @medpedshosp

Coagulopathy in COVID-19: Manifestations and management

Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with...

www.ccjm.org

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

One of our outstanding CCM fellows practicing intubation and bronchial blocker at the MICU sim lab @ClevelandClinic before caring for massive hemoptysis. Practice makes perfect. @CCF_PCCM @NealChaisson @msiuba @KapoorA_CC @angelcozyataco @TRGildea @AbhiDuggalMD @siddharth_dugar

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

SEVA VentRounds en Español Martes 15 Marzo 2 PM (UTC-5) Gratuito Link @LuisFer37729634 @MonaresTI @DocMusician @OrlandoRPN @medpedshosp @JmNunezSilveira @curso_vm @ventilacionmeca @ArielG_RRT @casita1981 @snamendys @joagom @DrMiguelIbarra1 Que ven?

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Eduardo Mireles-Cabodevila

@emireles_c

11 months

A fantastic day with an amazing team!

Silvio A. Ñamendys-Silva

@snamendys

11 months

The First International #SEVA Course #SEVAVentRounds Thanks @emireles_c @RobChatburn @ClevelandClinic

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Eduardo Mireles-Cabodevila

@emireles_c

9 months

Not surprised, implementation is hard. Wouldn’t it be nice if the ventilator would give you a percent of time the patients has unsafe ventilation? Or a safety score? Granted we would have to agree on these 😱, or be able to select which….

CHEST

@accpchest

9 months

Research in the United Kingdom and the United States shows a median tidal volume >8 mL/kg predicted body weight was associated with worse patient outcomes. Read more in the February @journal_CHEST issue: #MedEd #MedTwitter

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Another group achieves SEVAmaster level certification @ClevelandClinic . 6 more Respiratory therapists got the coveted pin on #RespiratoryCareWeek @ArielG_RRT @Sherry2517 @msiuba @RaedDweikMD @aarc_tweets @AGMRRT @JieLiRRT @RobChatburn @Rbranson1 @RespiratorySCCM @AARC_President

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

Working together to treat sepsis earlier. Matt Dettmer leading the charge. #manybrainsbetterthanone @NateHurle @ccfri @RaedDweikMD @AnitaJReddy @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

VentRounds today at 2 PM EST (UTC -4) here is the FREE Link and here is a taste courtesy of @DrSateeshPCCM . @CCF_PCCM @JHUPCCMFellows @Thind888 @msiuba @RobChatburn @AGMRRT @curso_vm @JmNunezSilveira @curso_vm @ventilacionmeca @OrlandoRPN @respresource

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

Celebrating the first year of our Medical Intensive Liver Unit led by @KapoorA_CC and Christina Lindenmeyer. A successful interprofessional team caring for liver disease patients. @RaedDweikMD @ccfri @CCF_PCCM #liverICU #clevelandclinicDDSI #CleClinicRespiratory

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

A good waveform from @Hawra_N95 the question is: If your goal is comfort (balanced work of breathing and synchrony) what do you change? @CCF_PCCM @msiuba @ArielG_RRT @OrlandoRPN @DocMusician @MegriMohammed @MonaresTI @respresource @JmNunezSilveira @AGMRRT @RespiratorySCCM

hawra_

@Hawra_N95

3 years

What do you think? #VentRounds

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

SEVA #VentRounds . will focus on Pmus and how to read it. Today at 2 PM EST. free. A taste of the challenge below @CCF_PCCM @msiuba @msenussiMDA @VashishtRishik @concernecus @DrivingPressure . @donnatanner815 @Sherry2517

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

My assessment here and a quick pic below. VC-IMV(1)s,s, with early trigger, expiratory work and what seems as a leak. Here is a rough explanation. What do you all think @some4mv @msiuba @Thind888 @MegriMohammed @ventilacionmeca @JmNunezSilveira @curso_vm @respresource @OrlandoRPN

Lawrence Zavorszky

@lzavorszky

3 years

Another perplexing vent curve for me. @msiuba @emireles_c What's going on here? Thanks for considering.

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Good reads. Indeed, it was ventilator dysfunction! It flipped the pressure waveform, while the flow waveform remained normal. I have never seen this! #ventrounds @MonaresTI @ArgaizR @cursovm @msiuba @respresource @msiuba @Thind888 #SoMe4MV

Eduardo Mireles-Cabodevila

@emireles_c

4 years

I was called today to see this waveform. Patient looks ill but overall calm. What does the #VentRounds group think is going on? @CCF_PCCM @MonaresTI @ArgaizR @cursovm @msiuba @respresource @msiuba @Thind888 #SoMe4MV

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Ryota Sato presenting study with ⁦⁦ @siddharth_dugar ⁩ the association of echo with better outcomes in septic shock from the national inpatient sample database! #sccm2023 #exccffellow ⁦ @CCF_PCCM ⁩ ⁦ @NealChaisson ⁩ ⁦ @msiuba ⁩ ⁦ @AbhiDuggalMD ⁩

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

At @CleClinicRespiratory reception #CCC49 , awesome crowd!

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Live SEVA VentRounds TODAY at 2 PM EST link: Topic is Resistance... so much to talk about in this image. @curso_vm @msiuba @chatterJ5 @JmNunezSilveira @CCF_PCCM @YalePCCSM @JHUPCCMFellows @msenussiMD @VashishtRishik @AbhiDuggalMD @MegriMohammed @AGMRRT

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Eduardo Mireles-Cabodevila

@emireles_c

9 months

Great day running the SEVA course at @JacksonHealth @UMiamiHealth . Lots of learning with new and old friends! Looking to more! @CCF_PCCM @RaedDweikMD @ArielG_RRT @msiuba @_MSAMEED @chatterJ5 @MegriMohammed @OfVentilation @Vent_Busters @aarc_tweets @RespiratorySCCM @Thind888

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Today at 2 PM EST SEVA VentRounds. Just when you think you knew it, more was found. Join us Free here @CCF_PCCM @JHUPCCMFellows @PCCSMChiefs @UChicagoPCCM @JmNunezSilveira @ventilacionmeca @SMHCoEMV @curso_vm @iceman_ex @MegriMohammed @msiuba @HawraaHH

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Bravo @msenussiMD , such a clear and organized process to assess congestion . Loved the video. Looking for more. Proud of our CCF critical care alumni. @CCF_PCCM @msiuba @siddharth_dugar @AbhiDuggalMD @PennyRampersad @RanLeeMD @carlosalviar @AndrewHigginsMD @venumenon10

Cardio Crit

@CardioCrit

3 years

"HOW TO ASSESS SHOCK The Congestion Cascade - Episode 1 - The Primer" Episode 1 provides the framework for understanding the congestion cascade and sets the stage for this year's season! @msenussiMD @Kartopia Premieres NOW! Be sure to subscribe!

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

No seats left at the @ClevelandClinic ECMO course, great simulations and speakers from a multidisciplinary team. @abribriesco43 teaching on cannulation nomenclature. . @AbhiDuggalMD @msiuba @CCF_PCCM @PennyRampersad @RanLeeMD @siddharth_dugar @Sherry2517

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Back to twitter after a hiatus. Arriving to #CHEST2022 . Will do SEVA VentRounds Monday at 2 PM EST link to follow. Live from Nashville. Will find a nice place and some cool waveforms @accpchest @msiuba @CCF_PCCM @AnnGageMD @CarlosAlviar5 @DrMiguelIbarra1 @ArielG_RRT @AnnGageMD

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

@siddharth_dugar @msiuba @Thind888 @krveshi A nice tweetorial for a horrible patient-ventilator discordance. Thank you @siddharth_dugar #VentRounds #FOAMed #SoMe4MV @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

We just added the last 5 #VentRounds to youtube @CCF_PCCM @YalePCCSM @JHUPCCMFellows @msiuba @AGMRRT @JmNunezSilveira @OrlandoRPN @DrMiguelIbarra1 @ArielG_RRT @OfVentilation @ventilacionmeca @Vent_Busters @some4mv @Thind888 @siddharth_dugar @SCCMohio

SEVA VentRounds (SVR)

SEVA VentRounds (SVR) is designed to offer live, online educational support for learning how to look at ventilator settings in order to evaluate the effectiv...

www.youtube.com

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Our Team is working very hard, day and night. Want to help us: Vaccinate.

ClevelandClinicNews

@CleClinicNews

3 years

The number of hospitalized patients w/ COVID-19 is among the highest since the pandemic started. The vast majority are unvaccinated. They are fathers. Mothers. Sisters. Sons. Neighbors. Care in our hospitals is safe, but we're near capacity. Please help us. Get vaccinated.

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Interesting study, as this is a common concept, sedation to deal with respiratory drive. A complex topic we need to clarify as it does affect care and likely outcomes. Thank you for sharing. @ventilacionmeca

Fede Gordo-Vidal

@ventilacionmeca

3 years

Discordance Between Respiratory Drive and Sedation Depth in Critically Ill Patients Receiving Mechanical Ventilation #SoMe4MV

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Even while flying, waveforms everywhere Can someone explain these?

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Finishing saga. It is a False trigger due to ventilator-induced artifact. @dileepraman brought a concern for a "reflex diaphragm contraction". We answered it with an advanced lung simulator, here is the analysis. #VentRounds #SoMe4MV @concernecus @RobChatburn @ArgaizR @msiuba

Eduardo Mireles-Cabodevila

@emireles_c

4 years

WOW. These were VERY challenging waveforms to read. Here are my thoughts, but expect controversy as this took me a while to decipher. #VentRounds #some4MV #MedTwitter @concernecus @RobChatburn @msiuba @aarc_tweets @donnatanner815 @CCF_PCCM @Thind888 @ArgaizR @MegriMohammed

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Eduardo Mireles-Cabodevila

@emireles_c

1 year

New SEVA VentRounds Videos! Controlling vs Targeting Volume Cheyne Stokes on the Ventilator Workshifting @pulmtoilet @ArielG_RRT @msiuba @Thind888 @DrMiguelIbarra1 @drdangayach @CCF_PCCM @RespiratorySCCM

SEVA VentRounds Express: Lots of Workshifting

For more information about the SEVA VentRounds, please visit https://cle.clinic/3M7bSOwA great example of severe work shifting and under assistance when usin...

www.youtube.com

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Eduardo Mireles-Cabodevila

@emireles_c

10 months

A busy day on service that was crowned with a fabulous education session by @ArgaizR and a great dinner with old and new friends! @CCF_PCCM @ClevelandClinic @RaedDweikMD @msiuba @siddharth_dugar @ErinCovert22 @KapoorA_CC @SimonMuchaMD

Eduardo R Argaiz

@ArgaizR

10 months

Fantastic Critical Care Nephrology Education Day and Venous Doppler Ultrasound workshop at Cleveland Clinic 🔥 Very humbled to have been invited as invited professor 🤯! Can’t deny I had the best company with friends @emireles_c @msiuba @siddharth_dugar 😃

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Eduardo Mireles-Cabodevila

@emireles_c

8 months

El nuevo equipo SEVA en Mexico y el equipo ganador! Y dos nuevos instructores @PacoDardon y Eduardo Cartagena. @vic_puente @RaedDweikMD @Sherry2517 @PacoDardon @msiuba @Thind888 @ArielG_RRT @_MSAMEED @DocMusician @MonaresTI @OfVentilation @pdsalinas @Jose_Diaz_Gomez @drtorruco

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

En la ultima SEVA VentRound en Español revisamos esto. Agradezco la participacion y enseñanzas de @ventilacionmeca y @ArielG_RRT Aqui el link a YouTube: @JmNunezSilveira @OrlandoRPN @DocMusician @santiUCI @SebastianRLL @MonaresTI @DrMiguelIbarra1

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Welcome to Twitter master RT professor @RobChatburn ! #VentRounds will get even better. @msiuba @siddharth_dugar @aarc_tweets #SoMe4MV

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Improving lung compliance by external compression of the chest wall, recently discussed by @Thind888 and @DrivingPressure . This review by master physiologists @gattinon & J Marini gives several ideas for research. @msiuba @RobChatburn @CCF_PCCM @curso_vm

Improving lung compliance by external compression of the chest wall - PubMed

As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related...

pubmed.ncbi.nlm.nih.gov

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

This February a fantastic ECMO course, great simulations and speakers from our multidisciplinary @ClevelandClinic team. @msiuba @abribriesco43 @CCF_PCCM @AbhiDuggalMD @RaedDweikMD @donnatanner815 @ChrisTroianos @medpedshosp @VashishtRishik #ecmo #CME

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Lets discuss this waveform and others tomorrow, SEVA VentRounds at 2 PM EST, Free, Open, Link here @curso_vm may make surprise appearance :) @msiuba @Thind888 @mkashiouris @AlexLawandi @TaisonBell @WApplefeld @CCF_PCCM @ventilacionmeca

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

Today SEVA VentRounds at 2 PM EST. free CRCE, join us for 30 min of ventilation education. NEW LINK: @msiuba @CCF_PCCM @DrMiguelIbarra1 @OrlandoRPN @ArielG_RRT @OfVentilation @RespiratorySCCM @SCCMohio @some4mv @ventilacionmeca @HawraaHH @aarc_tweets

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Last week we went deep into 4 examples of volume control at SEVA VentRounds @CCF_PCCM @CleClinicLungs @JHUPCCMFellows @YalePCCSM @msiuba @AbhiDuggalMD @siddharth_dugar @MegriMohammed @HawraaHH @be_an_rt @some4mv @JmNunezSilveira @curso_vm @DocMusician

SEVA VentRounds: Volume Control - Known Unknowns

For more information about the SEVA VentRounds, please visit https://cle.clinic/3M7bSOwWe discuss volume control (VC-CMVs) 4 cases: increased resistance, ris...

www.youtube.com

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Eduardo Mireles-Cabodevila

@emireles_c

10 months

SEVA program en el proximo congreso de neumología en Puebla, MX. Miercoles 13 de Marzo. Aun hay espacio, registrese en @SMNYCT @OfVentilation @DrMiguelIbarra1 @DocMusician @MonaresTI @OrlandoRPN @ArielG_RRT @carlosalviar @JmNunezSilveira @PacoDardon

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

I got the waveforms for tomorrow's Mexico VentRounds at 3PM EST. I love screens that keep the past shaded, full of clues. Here is the Link: @Karina_RS12 @curso_vm @JHUPCCMFellows @CCF_PCCM @UChicagoPCCM @UNMC_PCCM @SMHCoEMV @snamendys @msiuba #FOAMed

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Eduardo Mireles-Cabodevila

@emireles_c

5 years

The answer: 2 manifestations of early (reverse) trigger. At some point patient had a NAVA catheter inserted, see the attached tweets pictorials. Great job: @msiuba @MonaresTI @lillieannamd @Thind888 @nirosshan and many others. Cause: Over sedation... decreased... disappeared

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

@concernecus provided this ventilation puzzler. Look carefully, answer poll, response later today. #ventrounds #some4MV @msiuba @RobChatburn @ArgaizR @dileepraman @siddharth_dugar @aarc_tweets @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Do you think IMV is a bad choice? Lets analyze the modern implementations of this breath sequence at our next SEVA #VentRounds . Tuesday May 18, @ 2 PM EST. All welcome, free. Link @msiuba @some4mv @rbauld @CCF_PCCM @respresource @ventilacionmeca @SMHCoEMV

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

@curso_vm awesome case of diaphragmatic myoclonus. Let's discuss how to identify and manage at SEVA VentRounds this Tuesday, 2 PM EST it's free @ArielG_RRT @msiuba @CCF_PCCM @DrivingPressure @MSRC_TexasState @AGMRRT @SCCMohio @RespiratorySCCM @YalePCCSM

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Eduardo Mireles-Cabodevila

@emireles_c

2 years

This image from @respitroy seems benign, is it? Lets discuss tomorrow at SEVA VentRounds at 2 PM EST. Now offering AARC approved CRCEs! Link @be_an_rt @ArielG_RRT @AGMRRT @JieLiRRT @MSRC_TexasState @aarc_tweets @SCCMohio @RespiratorySCCM @JBradyScott

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Eduardo Mireles-Cabodevila

@emireles_c

9 months

Congrats Ivan Ramirez @ruvistay @curso_vm @JmNunezSilveira @ventilacionmeca et al on a very intensive MV course and publishing their outcomes. It takes a village and networking to move the needle forward to improve patient care!

Specific Training Improves the Detection and Management of Patient-Ventilator Asynchrony

BACKGROUND: Patient-ventilator asynchrony is common in patients undergoing mechanical ventilation. The proportion of health-care professionals capable of identifying and effectively managing differ...

rc.rcjournal.com

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Join us to discuss cool and controversial topics on dealing with SARS-CoV-2. Tomorrow and Saturday, Free Webinar with faculty from @ClevelandClinic across the world. Schedule and register here Day1 Sep 24: Day2 Sep 25: 8 AM EST

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Here is the SEVA VentRounds recording enjoy the amazing input from @Thind888 Ahmed Gohar and @RobChatburn . @MegriMohammed @msiuba @CCF_PCCM @RaedDweikMD @CleClinicRespir @some4mv @aarc_tweets @ventilacionmeca @AbhiDuggalMD @perez_protto @siddharth_dugar

SEVA VentRounds: Reading Patient Effort on the Waveforms

For more information about the SEVA VentRounds, please visit https://cle.clinic/3M7bSOwTo understand patient-ventilator interactions we must recognize the ma...

www.youtube.com

Eduardo Mireles-Cabodevila

@emireles_c

3 years

SEVA #VentRounds . will focus on Pmus and how to read it. Today at 2 PM EST. free. A taste of the challenge below @CCF_PCCM @msiuba @msenussiMDA @VashishtRishik @concernecus @DrivingPressure . @donnatanner815 @Sherry2517

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

No SEVA VentRounds today. See you January 11,2022. Looking to learn more together. @CleClinicLungs @Thind888 @msiuba @OrlandoRPN @JmNunezSilveira @HawraaHH @CCF_PCCM

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

Very cool waveform @SebastianRLL . I agree, this is consistent with early (reverse) trigger present, but used it to highlight time constant and increased resistive load. @msiuba @Thind888 #VentRounds #some4MV

Eduardo Mireles-Cabodevila

@emireles_c

4 years

@SebastianRLL @CleClinicRespir @siddharth_dugar @msiuba @jojorowsky @SebastianRLL The waveforms are consistent with increased resistance. In the setting of COVID (an not a COPD patient) the main concern these days is tube obstruction. See the tutorial on ETT obstruction by @msiuba

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Eduardo Mireles-Cabodevila

@emireles_c

4 years

This screen shot was sent for #Ventrounds by @hawraaHH @AUBMC_Official . What do you think is going on? @CCF_PCCM @some4mv @curso_vm @msiuba @JmNunezSilveira @DocMusician @MonaresTI Lets discuss live Tuesday March 23 at 2 PM EST. Click the link:

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

Agree, we explored this in critically ill patients. To ensure a risk of hidden hypoxemia of less than 10%, the Spo2 should be > 93% among Asian, 96% among Black, 92% among Hispanic, and 93% among White patients. @leocelli Ian Wong @ duke @MLCharpignon

Discrepancies Between Spo2 and Sao2 by Race and Ethnicity and Association With Outcomes

This cross-sectional study examines racial and ethnic discrepancies between oxygen saturation measured by pulse oximetry and arterial blood gas and their associations with clinical outcomes.

jamanetwork.com

Orlando RPN

@OrlandoRPN

3 years

Los oxímetros de pulso están calibrados con gente Blanca, las personas de piel Oscura pueden estar en riesgo SpO2 de 92% asegura una PaO2 superior a 60 mmHg en 91,7 % de px blancos 👨🏻‍🦰, pero solo en 50 % de pacientes negros👨🏿‍🦲 Sesgo estadístico y racial

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Eduardo Mireles-Cabodevila

@emireles_c

9 months

Was great to chat on our MICU inter-professional project to use peripheral norepinephrine with a great host @GallodeMoraesMD @CCF_PCCM @RaedDweikMD @siddharth_dugar @AnitaJReddy @StephanieNBass @SethRBauer @accpchest @elishaPA_C @msiuba @gretchensacha @AbhiDuggalMD

CHEST

@accpchest

9 months

Jason R. Yerke, PharmD, and Eduardo Mireles-Cabodevila, MD, join @journal_CHEST Podcast Moderator, Alice Gallo De Moraes, MD, FCCP, to discuss peripheral administration of norepinephrine. #JournalCHEST #MedEd #MedTwitter

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Eduardo Mireles-Cabodevila

@emireles_c

3 years

2-22-2022 SEVA VentRounds Reviewed 6 different causes of double triggering🤔with potentially different clinical consequences @CCF_PCCM @CleClinicLungs @msiuba @OrlandoRPN @ventilacionmeca @some4mv @MegriMohammed @aarc_tweets @siddharth_dugar @AbhiDuggalMD

SEVA VentRounds: Double Triggers on 2day 2-22-2022

For more information about the SEVA VentRounds, please visit https://cle.clinic/3M7bSOwWe discuss double trigger and its multiple causes (early trigger, earl...

www.youtube.com

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