mechanical ventilation graphical assessment

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Mechanical Ventilation Graphical Assessment

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Mechanical Ventilation Graphical Assessment . Ventilator scalars and loops Control variables Phase variables Other settings Breath types Breath sequence Modes of ventilations. Outline. Mechanical Ventilation Graphical Assessment . Ventilator Scalars and loops. Peak P AW. Plateau P AW. - PowerPoint PPT Presentation

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Page 1: Mechanical Ventilation Graphical Assessment

Mechanical Ventilation Graphical Assessment

Page 2: Mechanical Ventilation Graphical Assessment

OUTLINE

Ventilator scalars and loopsControl variablesPhase variablesOther settingsBreath typesBreath sequenceModes of ventilations

Page 3: Mechanical Ventilation Graphical Assessment

VENTILATOR SCALARS AND LOOPS

Mechanical Ventilation Graphical Assessment

Page 4: Mechanical Ventilation Graphical Assessment

PAW

Pes

cmH2O

V

L/m

L

cmH2O

50

0

0

60

-601

0

0

30

-20Seconds2 10864 12 14 160

Inspiratory Time

Peak PAW

Plateau PAW

Peak Inspiratory Flow

Peak Expiratory Flow

Zero Flow at Plateau Phase

End Expiratory PAW

Inspiratory Flow Time

Inspiratory Hold Time

End Inspiratory Esophageal Pressure

End Expiratory Esophageal Pressure

Expiratory Time Tidal Volume

PRAW

Page 5: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V°L/m

50

0

0

60

-60

Seconds2 10864 12 14 160

Volu

me

(L)

0

-5 0 35PAW (cm H2O)

Flow

(L/m

in)

80

0 0.8

Volume (L)-80

0.7

Page 6: Mechanical Ventilation Graphical Assessment

Volu

me

(L)

0

0.7

-5 0 35PAW (cm H2O)

Flow

(L/m

in)

80

0 0.8Volume (L)

-80

Plateau Airway PressurePeak Airway Pressure

VT

End Expiratory Pressure

Peak Inspiratory Flow

Peak Expiratory Flow

Tidal Volume (VT)

Page 7: Mechanical Ventilation Graphical Assessment

CONTROL VARIABLESMechanical Ventilation Graphical Assessment

Page 8: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Lung Compliance Decreased

Set Tidal Volume Maintained

Page 9: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Lung Compliance Decreased

Set Pressure Maintained

Delivered VT Decreased

Page 10: Mechanical Ventilation Graphical Assessment

PHASE VARIABLESMechanical Ventilation Graphical Assessment

Page 11: Mechanical Ventilation Graphical Assessment

PAW

Pes

cmH2O

V

L/m

L

cmH2O

50

0

0

60

-601

0

0

30

-201 second

Pressure Trigger Sensitivity

Flow Trigger Sensitivity

A B C

Page 12: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

01 second

A B C

Pressure Limited

Flow Limited Flow Limited

Volume Limited

Page 13: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

01 second

A B CTime Cycled

Set Volume

Time CycledVolume Cycled

Set Time Set Time

Page 14: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

01 second

D E F

Set Flow Cycle at 25%Of Peak Inspiratory Flow

Back Up Time Cycle is activated

Set Pressure

Set flow cycle at 25% ofpeak inspiratory flow wasnot reached

Flow Cycled Flow/Time CycledPressure Cycled

Page 15: Mechanical Ventilation Graphical Assessment

OTHER SETTINGSMechanical Ventilation Graphical Assessment

Page 16: Mechanical Ventilation Graphical Assessment

PAWcmH2O

50

0

Seconds

2 10864 12 14 16 18

PAWcmH2O

50

0

Set respiratory rate= 12/min

3.5 seconds

60 seconds/12 = 5 seconds for each respiratory cycle

Set: 1.5 seconds

I:E Ratio = 1:2.3Set respiratory rate= 15/min

2.5 seconds

60 seconds/15 = 4 seconds for each respiratory cycle

Set: 1.5 seconds

I:E Ratio = 1:1.6

Page 17: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Inspiratory Time

Inspiratory Flow Time

Inspiratory Hold Time

Expiratory Time

Set respiratory rate= 12/min

3.5 seconds

60 seconds/12 = 5 seconds for each respiratory cycle

Set: 1.5 seconds

I:E Ratio = 1:2.3

Page 18: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Shorter Inspiratory Flow Time

Longer Inspiratory Hold Time

Same Set IInspiratory Time

Higher Set Flow Rate

Page 19: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

01 second

TI TE

Page 20: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

01 second

Exponential-decay Rectangular Ascending-ramp Sinusoidal

Page 21: Mechanical Ventilation Graphical Assessment

BREATH TYPESMechanical Ventilation Graphical Assessment

Page 22: Mechanical Ventilation Graphical Assessment

PAW

Pes

cmH2O

V

L/m

L

cmH2O

50

0

0

60

-601

0

0

30

-201 second

A B D

Spontaneous Breath Mandatory BreathSupported Breath

C

Assisted Breath

Flow Control

Volume Cycle

Patient Triggered

Time Cycle

Flow Control

Time TriggeredPatient Triggered

Flow Cycled

Pressure Limited

Patient Triggered

Patient’s Flow

Patient’s Cycle

Page 23: Mechanical Ventilation Graphical Assessment

BREATH SEQUENCESMechanical Ventilation Graphical Assessment

Page 24: Mechanical Ventilation Graphical Assessment

PAWcmH2O

50

0

PAWcmH2O

50

0

PAWcmH2O

50

0

Continuous Mandatory Ventilation

Intermittent Mandatory Ventilation

Continuous Spontaneous Ventilation

Page 25: Mechanical Ventilation Graphical Assessment

MODES OF VENTILATIONMechanical Ventilation Graphical Assessment

Page 26: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 27: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 28: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 29: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 30: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 31: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 32: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 160

Page 33: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 16 18

Page 34: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 16 18

Page 35: Mechanical Ventilation Graphical Assessment

PAWcmH2O

V

L/m

L

50

0

0

60

-601

0

Seconds

2 10864 12 14 16 18

5 cm H2O Test BreathPressure Adjusted 2-3 cm H2O each breath to Achieve Target Volume

Pressure Maintained

Higher Tidal Volume

Low Tidal Volume

Tidal Volume StillLower than Target

Target Tidal Volume Achieved

Pressure Decreased

Pressure Alarm LimitPressure Limit

Set Tidal Volume

Page 36: Mechanical Ventilation Graphical Assessment

THANK YOU