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.