Ventilating Severe Acidosis: ResusX edition!

Ventilating Severe Acidosis: ResusX edition!

Running back my talk from ResusX about ventilating severe acidosis! I try to approach this from a pragmatic perspective! Nothing will work great so just do the least bad thing!!

What is SIMV?

We all know SIMV sucks, but what exactly is the difference between SIMV and AC?

Autopeep discussion from Instagram waveform!

My thoughts on a waveform question from April 17 on my Instagram @pulmtoilet !!! Go check it out !

Pressure Control 2 Webinar Sample : Abnormal Waveforms!

In this episode of Peak Inspiration, we’re bringing you a high-yield excerpt from the Pressure Control Part 2 webinar, focused on one of the most practical skills in mechanical ventilation—recognizing abnormal waveforms. We break down how to interpret pressure, flow, and volume waveforms through the lens of the equation of motion, helping you pinpoint whether the issue lies in resistance, compliance, or patient effort. Instead of memorizing patterns, this episode teaches you how to think through the waveform so you can quickly identify what’s wrong at the bedside. If you’ve ever looked at a ventilator and felt like something was off but couldn’t quite explain why, this episode will sharpen that instinct and give you a framework you can apply immediately.

Autotrigger & the Airway Occlusion Pressure

When the ventilator triggers a breath the patient didn't ask for, something has gone wrong. In this episode we dig into autotrigger: why it happens, how to spot it at the bedside, and the cascade of harm it can set off when it goes unrecognized. Then we turn to one of the most underused numbers on the ventilator screen: the airway occlusion pressure (P0.1). This 100-millisecond window into the respiratory drive tells you things that tidal volume and respiratory rate simply can't — how hard the brainstem is working before flow has even begun. We break down the physiology behind it, walk through how to measure and interpret it, and explore how P0.1 can serve as both a trigger-sensitivity troubleshooting tool and a real-time gauge of patient effort and diaphragm load. Along the way we tackle practical questions: what P0.1 thresholds should raise concern, how autotrigger and elevated drive interact with patient-ventilator asynchrony, and when you should let the number change your clinical decisions. Whether you're a fellow just getting comfortable with modes and waveforms or an experienced intensivist looking for a sharper framework, this episode gives you a cleaner mental model for one of ventilation's trickier corners.