Wednesday, February 6, 2008

New Kind of Ventilator

One thing I haven't mentioned that I have been wanting to:

Tricia had been on a very new kind of ventilator setting. She is one of the very first patients to use this new vent setting at Duke...literally none of her doctors, nurses or respiratory therapists have ever used this vent setting before...they've had to pull out the manual to figure it out (and they've done a great job)! Let me try to explain as best I can ('cause I'm still learning, and I may not describe all of this very well). This may not interest you much, so please, forgive me if I bore you.

The traditional mechanical ventilator can basically do three things:

> Set the pace for your rate of breathing (how fast or slow your breathe).

> Set the "tidal volume" for each breath (how big each breath is).

> Set a percentage of gas (O2) for each breath.

There are two basic settings (at least, that Tricia has been on) with the traditional vent:

> When she was totally paralyzed and sedated immediately after being intubated, the vent was doing all the work for her. It was setting the pace and giving her an exact amount of volume and O2 each breath.

> After she was taken off the paralytic, the settings were changed so that she began to do some of the work. She helped to determine the pace, but the volume and O2 levels were still set by the vent.

Tricia's body and mind were having issues with the traditional vent settings, no matter how much they tweaked them, so the decision was made to try her out on these new settings.

The vents at Duke are basically computers...the vent settings she's on now is literally an upgrade in the software (I'm sure it's more complicated than that, but that's how it was explained to me).

The new setting is more reactionary than the traditional vent settings. Instead of setting the pace and giving her a set amount of volume for each breath, it gives her a set percentage "support" which allows Tricia to have almost total control over the vent.

For example, right now, Tricia is on 70% support (and 35% O2). This means that, any breath that Tricia decides to take, the vent will do exactly 70% of the work for her, and she'll do exactly 30%. If Tricia wants to take a huge breath with a tidal volume in the 400's, her act of breathing will trigger the vent to do 70% of the work. If Tricia wants to take a small breath in the 100's, the vent will do 70% of the work. If Tricia wants to hold her breath, the vent will not do anything but make lots of loud alarms.

Tricia has thrived on this new setting. While she was not able to be weaned at all on the traditional settings, she was weaned immediately on the new settings.

From what I've been able to gather, this setting is fairly new in the states, but has been used for a little while longer in England (maybe Europe?).

Anyway, that's about all I know about that. If I learn that any of my info was incorrect, or if I can learn some more important info about this new vent setting, I will make the correction/addition and bump this post up to the top.

Thanks!

Nate

53 comments:

The Nanny said...

Technology is amazing. Go Tricia GO!!!

Anonymous said...

Praise the Lord for the capable Doctors, Nurses and staff at Duke!!!

Anonymous said...

That new vent setting sounds AWESOME!!! I am a Respriatory Therapist in Iowa and of course our vents aren't even close to doing that!!! You guys are in the right place!!

Anonymous said...

Guess God knew what he was doing huh? When Tricia's family moved...brought you two together, and her close to the hospital where she needed to be for the amazing care that she needs/deserves. And the same great care for sweet little Gwyneth.(btw, REALLY missed seeing a "Tuesday" picture update! I know, like you have nothing going on!)
Continued Blessings to you 3!

Mandy said...

We are so encouraged by every small detail of your story. Thanks so much for sharing so openly. We are praying for you, Tricia and baby Gwyneth. Your "Safe and Sound" video was amazing! I shared your story on my blog at http://jansenclan.blogspot.com

Blessings to you!
Mandy

Princess Talana said...

Thanks for this post Nate... I'm facinated by vents and this was really cool to read and very educational.

naomi silliman said...

You 3 are at the top of my prayer list! Thank you for allowing us to see pictures and the video was awesome! I will be telling my friends to be praying too!!! Keep smiling!
Naomi

Anonymous said...

Technology is going places that I never could have imagined. Let's hope that tricia doesn't practice the holding her breathe so the alarms go off part of the post very often!!!!!! You guys are still in my prayers.
-Bobbi

Will and Will's family said...

Thanks for the info about the new vents. We are awaiting our son's lung transplants also. I have commented before this one. But all the new info that you put out there helps people like us in Salt Lake City to understand more of what's going on. Our son, Will has been waiting four months now. It could be any day. Our prayers are with you and your ladies. Such a terrific family. Say a prayer for Will too, would ya? Keep on Keepin on. God bless you and all your huge, supportive family.

Sara said...

Thanks for sharing that info Nate, I do biomedical research of infectious diseases in England, so things like vents is very interesting to me! I look forward to your updates & keep all 3 of you in my thoughts & prayers. all the best mate!

Anonymous said...

Oh that is very cool.

Tricia is my kind of person. I could just see her playing around trying to get that vent to make noises.

When I was at UNC hospitals, I played around with my eyebrows, nose, and mouth trying to get the EEG to do funny squiggly lines on the tv monitor. Hey when you're in the hospital, there's only so much lying in bed you can do before you come up with your own entertainment. My one "game" was to see how fast I could get the interns and nurses running. It was never anything dangerous. I found the fastest way was by to start getting out of the bed.

jel said...

that is cool!


hangin there Tricia,

blessings on the day!

Scott said...

You gotta love technology whether you can explain/understand it all or not. Praying for you guys daily. Thanks for the update.

Anonymous said...

This sounds great. I am glad that Tricia is just getting better and better. Gwyneth too.

I was just wondering why there has been a drastic drop in the number of comments. There used to be 100-300 comments after one of your post, now there is usually less than 50. Maybe it is just the simple fact that people are not commenting anymore,(DUH) But I didn't know if you were removing some of them or not. Just curious.
I am still praying.(and commenting) :)
-Indiana

Carol said...

THANKS for the explain of the new vent settings. Pretty cool!

YOu all continue to be in my prayers.

refreshing in ohio said...

Very cool...praying for knowledge of all new things!

Just watched the 'safe and sound' montage AGAIN and cried even harder than the last time! You have a gift. Although, I'm not sure it would mean so much to someone who hasn't spent everyday with you for the last month - thank you, thank you, thank you AGAIN for sharing that beautiful moment! The highlight to this day...

Now, I'll go listen to my download of 'safe and sound' on my ipod! (which I will think of you all everytime I hear it! Perfect song, by the way!)

Still praying, as always!

Michelle said...

wow! that is really amazing and so is Tricia!

Anonymous said...

Continued prayers for both Tricia and Gwyneth!

Anonymous said...

Love to all.

Anonymous said...

That's amazing to me. Thank the Lord for new technology. I had breast cancer in 2000 and 2005, and the advances in those 5 years were unbelievable. I'm so glad this is working well for Tricia. We're praying for you all in Michigan!

Wendy said...

I read on your wife's blog that she is also a diabetic. I am curious as to why they are not planning to give her a new pancreas at the same time as her new lungs. This is getting more and more common in CF patients who need transplants. I know this because my CF daughter received a liver/pancreas in October 2007. I discovered this new trend when my daughter was listed for just a liver. I kept questioning the doctors about it - and they decided that the dual transplant was the best thing to do. A new pancreas increases the chances of a successful transplant. My child was left on the transplant list for liver while the workup for the pancreas was completed. Luckily, she was not called for transplant until the dual listing was completed. Her recovery has been AMAZING. I know each case is different. Just thought I would mention it. Living without insulin and enzymes is a blessing.

Franceskasjourneyhome said...

I am so thankful to GOD for amazing technology!! You go Tricia!!!

Mary said...

"If Tricia wants to hold her breath, the vent will not do anything but make lots of loud alarms." That made me giggle, and believe me, I needed that this morning.

Mary
Florida

TruePraise said...

very cool! You guys are definately in the right place at the right time!

Jane-Jane said...

can you imagine being the first person to hear "we are going to break every one of your ribs and operate on your heart!" Someone has to be the first....so very happy that it is working. Modern medicine is sooo amazing with the aid of computers.

still praying!

katie said...

How cool is technology! Go God!

Anonymous said...

Go Tricia!
The McLamb's
Clayton, NC

Emily said...

That's awesome! It sounds similar to what my daughter was on when she was trached, pressure support. Anytime she would take a breathe the ventilator would jump in and help support that breathe so it was larger. She still had to be on mechanical breathes as well but the pressure support helped out a great deal.

Anonymous said...

What a truly amazing family you, Tricia and Gwenyth are!! You are truly bless by GOD, as we are all blessed to be able to be part of your amazing lives through your wonderful blog. Thank you. Prayers and love to you all.

BuckeyeNP said...

Well Nate if ministry & worship leading doesn't work out, you should venture into pulmonary critical care. Very impressive explanation!! Glad to hear that they've found a perfect fit for Tricia at this stage.

A stranger in Canada said...

Thank God for medical technology and advances!!!

Patty said...

Very cool!

Laurie said...

I am amazed at the things being done these days, new all the time. I am so glad that Tricia is moving along at the best pace she can do and praying for her to be patient with herself and peaceful. The three of you are in my daily prayers and asking God to bring about the necessary progress in His time. You are so great at keeping us updated. Thank you Nate.

Laurie in Ca.

Julie said...

Sounds pretty complicated, but the good news is that Tricia is doing a lot better on this new vent. That will probably help her get healthier faster then, right? Which would get her on the transplant list faster, right? EXCELLENT!! (The previous statements are just assumptions, so feel free to correct me if I'm wrong)Still praying for you all!

Anonymous said...

You are truly amazing. I don't pray much but I will say a big prayer for you all today...so know that it is super prayer powered. I save those up for times when they are really needed. :o)

ApplePieMom said...

That is absolutely fascinating...I haven't worked with vents as a nurse for 4 years now but it's amazing to hear about the strides that medicine is making. I'm so glad that it is helping Tricia and that the doctors/nurses/RTs were willing to give it a try!

Am I doing okay? said...

Last night I clicked through almost every post. I must have hit that newer button over a hundred times. I was looking for the post when you announced your pregnancy. I am riveted by your story, praying for you all and intend to blog about your blog today.

Baby Leino said...

Thanks for the update, Nathan. Its amazing how sophisticated vents can be. Tricia, you're doing an AWESOME job! We're all so proud of you both.

walkingbyfaith said...

Thank you for the info. It's neat to actually hear what's going on and how everything works.

Still praying hard for your sweet family.

Hugs & Love to y'all!

Erika and Matt said...

Thanks for the new info! Technology is pretty cool! Have a great day! Thoughts and prayers from snowy Chicago!

Anonymous said...

Does 70% support mean when she gets her new lungs she will need support?

Anonymous said...

nate
just wanted to say how much a blessing your story has been to my life. So with that said,this morning i sent your web site to WMIT 106.9 matt and carol in the morning show, I have encouraged Carol to share your story with their audience. I think the whole world should know what God is doing in your lives.

Larissa said...

Amazing... I'm so glad breathing is working for her! (hmm, i take so much for granted....) Praise God for the "upgrade.! I'm continuing to pray for strength, healing, rest, peace, and joy, for all of you.

Lisa Bylander said...

Wow! That is so cool. I wonder if they're using Neurally Adjusted Ventilatory Assist (NAVA)? This is pretty new technology. We're about to start inservicing on it at my hospital. I'm an RT in a children's hospital so Tricia and Gwynneth's stories are particularly close to my heart. I pray for continued healing for both of your girls. God bless.
Lisa

listeningfordirection said...

Just wanted to let you know that when my husband's snoring woke me up in the middle of the night last night you all were on my mind. So I prayed. I don't know if you needed any special prayer in the middle of the night but God sure laid you all on my heart. Praying in Missouri!

Sarah

Anonymous said...

I just wanted you to know that I check the blog often and am praying for you and your family.

May God hold ya'll in the palm of his hand!

Anonymous said...

Your story makes me not take my life, health, and healthy children for granted.

Thank you for sharing.

sara said...

yay for a new ventilator! glad to hear she's still improving :)

God bless

AlaneM said...

That is WAY cool! Praise God this is working for her, you go girl!!

Anonymous said...

I just wanted to say that I have become addicted to your blog. A friend of mine posted about Tricia & I figured I would check it out. That was the end. I am in awe of how Tricia & Gwyneth are doing. They are amazing as are you Nate. I can feel the love you have for your daughter & wife. You are truly blessed by God!!

Candy said...

Medical technology is absolutely amazing. I am so glad that the Lord has gifted His sons and daughters with such talents. I continue to pray for you all daily. And while it's difficult to pray for, I've taken note from Nathan's post on how to pray for a donor and his/her family. May you be richly blessed with new lungs soon, Tricia!

tammy b said...

cool.

Jessica said...

Nate, I think you've earned your honorary respiratory therapist certification! Do you know what this new ventilator mode is called?