MV New Modes - NEWER VENTILATORY MODES: RATIONALE RATIONALE...

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NEWER VENTILATORY MODES: RATIONALE & CLINICAL APPLICATION Dr. SACHIN KUMAR SENIOR RESIDENT PULMONARY & CRITICAL CARE
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EVOLUTION OF MECHANICAL ENTILATORS VENTILATORS VOLUME ONTROL CONTROL PRESSURE CONTROL/ DUAL SUPPORT MODE
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Classifying Modes of Ventilation A. Start Trigger mechanism: What starts the breath? B. Limits What is controlled and what is variable? C. End Cycle mechanism: What causes the breath to end?
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rgeting Targeting Control Target Flow Time Volume ressure ressure control Pressure Pressure
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rgeting Targeting Control Target Flow Time Time cycled ressure ressure pressure control Pressure Pressure Volume
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rgeting Targeting Control Target Flow Time ressure ressure Pressure Pressure Volume targeted pressure control
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Microprocessor Control Microprocessor solenoid idal volume 500 ml Pressure 3500 cm H 2 0 Tidal volume 500 ml Pressure 35 cm H 2 0
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New Modes of Mechanical Ventilation: Background Introduction of the microprocessor controlled ventilator Better control of flow & exhalation valves Increased monitoring capabilities creased pt ntilator interaction Increased pt ventilator interaction “Dual modes” of ventilation troduced introduced From Mosby’s R. C. Equip., 6th ed. 1999.
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The Problem: Conventional Ventilation Ideal Mode of Ventilation Delivers a breath that: Synchronizes with the patient’s spontaneous respiratory effort aintains adequate and Maintains adequate and consistent tidal volume and minute ventilation at w airway pressures low airway pressures Responds to rapid changes in pulmonary mechanics or py patient demand Provides the lowest ossible WOB possible WOB
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hy new modes? Why new modes? Conventional modes are uncomfortable Need for heavily sedation & paralysis Patients should be awake and interacting with the ventilator To enable patients to allow spontaneous breath n inverse ratio ventilation on inverse ratio ventilation Lung protective ventilation : VILI ientific jargon : umber of studies on Scientific jargon : Number of studies on ventilatory modes exceed the number of patients eated ! treated !
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OLUME VS PRESSURE VOLUME VS PRESSURE VOLUME CONTROL PRESSURE CONTROL
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Newer Methods of Ventilatory Support: dual modes 1st generation dual modes: VAPS, Press. Aug., PRVC & VS Allow variable flow delivery and pressure “ argeted” ventilation approach targeted ventilation approach Attempt to deliver a set tidal volume (TV) Allow peak airway pressure to vary breath to breath
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ew Modes of Mechanical Ventilation: New Modes of Mechanical Ventilation: Examples of the first dual modes Volume Assured Pressure Support (VAPS) & Pressure Augmentation ressure Regulated Volume Control (PRVC) Pressure Regulated Volume Control (PRVC) & similar modes Volume Support Ventilation (VS or VSV) & similar modes
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VAPS : V olume A ssured P ressure S upport ombines volume ventilation & pressure support Combines volume ventilation & pressure support (for mech., vol. limited breaths only)
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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MV New Modes - NEWER VENTILATORY MODES: RATIONALE RATIONALE...

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