Speaking mode on Esprit

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April 08, 2010, 07:41 PM
Speaking mode on Esprit
Hi is there anyone out there using the speaking mode in the Esprit vent? We have both Servo-I and Esprit. We have a couple of patients where the doc has an order : PPRVC 10 VT 600 PEEP 8 SPEAKING MODE ESPRIT UP TO 30 MIN 6X DAY AS TOLERATED. Pt has a #6 trach, blue line ( has a sub glottic suction)
So we have to switch vents each time we attempt speaking mode.
PT IS HIV +, S/P PCARINI PNA, PE, RSV, he is a miracle right now. We had him on roto-bed, high frequency, inverse ratio, and inhaled Nitiric oxide. His outcome was bleek, he is surviving and somewhat aware of things.
OK anyone using it, after my long story.....???
April 09, 2010, 03:21 PM
We have installed speaking mode on most of our vents. We have used it with good results on several patients. One of the main problems we have is many of our patients come to us with trachs that are too large in diameter to allow enough flow around the trach to prevent the machine from jumping out of the mode. Are you having problems with your patient?
April 09, 2010, 03:44 PM
Well he ( the one I spoke of) is still weak tolerating only 5-10 minutes at the most. Some times not at all. Do you do anything with the alarms or change any of the settings to suit your patients. This is new to us and there is no proper education on the mode, nor is there any patient population/condition information.
Thank you for the reply.
I did use it months ago, on three patients who were very good candidates and they did not need the support. I am still figuring it out.
April 19, 2010, 04:06 PM
IMHO you will have the best luck with Speaking Mode (SM) on the Esprit in PCV-AC. I recomend adjusting IP to about what they are taking on VCV and Ti to match what apears to be their need. Adjust rise time a little lower than you might normally and you won't hit the IP alarm as often. A higher rise time is actually better as the more air you get in while they are pulling inspiratoin the better, but with higher rise times you will run the chance of hitting the IP alarm more. We use the alarms that about the same as we would if we were not in SM. The machine zeros out the PEEP and eliminates the return volume alarms itself when you activate the mode. I suggest, if you do not have it, ask your Philips rep for the Esprit Operator Manual section on Speaking Mode.