The Cribsiders S7 Ep169: A Breath of Fresh Air: Non-invasive Respiratory Support
Feb 25, 2026
Dr. Michelle Perez, pediatric intensivist and PICU fellowship director focused on ICU quality and respiratory failure. She unpacks HFNC, CPAP and BiPAP in kids. Short takes on physiology, when to pick each modality, recognizing failure and when to escalate. Practical talk on interfaces, settings, and family counseling.
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Fellowship Intubation Taught The Value Of Stepping Back
- Michelle Perez described early-fellowship intubation where repeated troubleshooting revealed a disconnected ventilator piece, teaching her to step back and rethink when things go wrong.
- That failure instilled the habit of pausing and asking colleagues for fresh perspective during confusing scenarios.
Oxygenation Versus Ventilation Simplified
- Oxygenation depends on mean airway pressure and FiO2 while ventilation controls CO2 via tidal volume and rate.
- PEEP increases mean airway pressure to improve oxygenation; inspiratory pressure increases ventilation by enlarging breaths.
Choose CPAP For Oxygenation And BiPAP For Ventilation
- Use CPAP to treat hypoxemia by increasing mean airway pressure and use BiPAP when you need ventilatory support as well.
- BiPAP gives IPAP and EPAP; the difference provides driving pressure to augment breaths.