sujatad

Hello Amir- these two attached documents will help you in practical management of severe hyponatremia. While you are correcting serum sodium to bring it to safe levels, you must determine the cause and try to treat the cause too. sodium-chloride-3-18022021-3.0.pdf TPA-53-55.pdf

Thank you all for clarifying this concept for me. All replies were helpful.

I need help to clear a doubt on mechanics of HFOV with VG. We use Fabian ventilator with HFOV. It is known that increasing frequency on HFOV decreases CO2 washout ( although that's not a change we prefer as most of us alter the amplitude for a desired change in CO2). However occasionally we use the VG mode on HFOV ( HFOV + VG). It was recently pointed out by a colleague that if VG is on with HFOV, increasing the frequency has the opposite effect on CO2 wash out as compared to HFOV without VG. Since I was not aware of this I searched for guidelines on this but could not find any literature which clarifies this concept for me. On working out theoretically I did come to the conclusion that this could be true since targeted tidal volume remains constant on HFOV+ VG so increasing the frequency increases DCO2 and therefore facilities CO2 washout ( unlike the case in HFOV without VG). I am aware that this topic is very theoretical as in practice most of us like to alter the amplitude ( HFOV without VG) or target tidal volume ( HFOV + VG) for a desired change in CO2 and rarely alter the frequency. However, getting this doubt cleared is important for me and I would be grateful for clarification on this by experts on this group. Thanks

Here are some articles which may help to decide initial settings for duopap on Fabian ventilator. Duopap in vlbw RDS china study 2014.pdf Duopap review article.pdf