Mechanical Ventilation Graphical Assessment

1. Mechanical Ventilation Graphical Assessment

2. Ventilator scalars and loops Control variables Phase variables Other settings Breath types Breath sequence Modes of ventilations Outline

3. Mechanical Ventilation Graphical Assessment Ventilator Scalars and loops

4. Peak PAW Plateau PAW PRAW End Expiratory PAW Peak Inspiratory Flow Inspiratory Flow Time Zero Flow at Plateau Phase Inspiratory Hold Time Peak Expiratory Flow Inspiratory Time Expiratory Time Tidal Volume End Inspiratory Esophageal Pressure End Expiratory Esophageal Pressure

6. Peak Airway Pressure Plateau Airway Pressure Peak Inspiratory Flow VT Tidal Volume (VT) Peak Expiratory Flow End Expiratory Pressure

7. Mechanical Ventilation Graphical Assessment Control Variables

8. Lung Compliance Decreased Set Tidal Volume Maintained

9. Set Pressure Maintained Lung Compliance Decreased Delivered VT Decreased

10. Mechanical Ventilation Graphical Assessment Phase Variables

11. A B C Pressure Trigger Sensitivity Flow Trigger Sensitivity

12. A B C Pressure Limited Flow Limited Flow Limited Volume Limited

13. A B C Time Cycled Volume Cycled Time Cycled Set Time Set Time Set Volume

14. D E F Flow Cycled Pressure Cycled Flow/Time Cycled Set Pressure Set Flow Cycle at 25% Of Peak Inspiratory Flow Set flow cycle at 25% of peak inspiratory flow was not reached Back Up Time Cycle is activated

15. Mechanical Ventilation Graphical Assessment Other Settings

16. Set respiratory rate= 12/min 60 seconds/12 = 5 seconds for each respiratory cycle Set: 1.5 seconds 3.5 seconds I:E Ratio = 1:2.3 Set respiratory rate= 15/min 60 seconds/15 = 4 seconds for each respiratory cycle Set: 1.5 seconds 2.5 seconds I:E Ratio = 1:1.6

17. Set respiratory rate= 12/min 60 seconds/12 = 5 seconds for each respiratory cycle Set: 1.5 seconds 3.5 seconds I:E Ratio = 1:2.3 Inspiratory Flow Time Inspiratory Hold Time Inspiratory Time Expiratory Time

18. Same Set IInspiratory Time Higher Set Flow Rate Longer Inspiratory Hold Time Shorter Inspiratory Flow Time

19. TI TE

20. Exponential-decay Rectangular Ascending-ramp Sinusoidal

21. Mechanical Ventilation Graphical Assessment Breath Types

22. A B C D Pressure Limited Patient Triggered Patient Triggered Time Triggered Patient Triggered Flow Control Flow Control Flow Cycled Patient’s Flow Time Cycle Patient’s Cycle Volume Cycle Spontaneous Breath Supported Breath Assisted Breath Mandatory Breath

23. Mechanical Ventilation Graphical Assessment Breath Sequences

24. 50 PAW cmH2O 0 Continuous Mandatory Ventilation 50 PAW cmH2O 0 Intermittent Mandatory Ventilation 50 PAW cmH2O 0 Continuous Spontaneous Ventilation

25. Mechanical Ventilation Graphical Assessment Modes of Ventilation

35. Pressure Limit Pressure Alarm Limit Pressure Adjusted 2-3 cm H2O each breath to Achieve Target Volume Pressure Maintained Pressure Decreased 5 cm H2O Test Breath Higher Tidal Volume Target Tidal Volume Achieved Tidal Volume Still Lower than Target Set Tidal Volume Low Tidal Volume

36. Thank you