Mechanical_Ventilation

Mechanical_Ventilation - MECHANICAL VENTILATION Marc...

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Unformatted text preview: MECHANICAL VENTILATION Marc Charles Parent Presentation Different settings to consider Monitoring of the patient Different type of patient COPD, Asthma ARDS Trouble shooting Ventilator settings Ventilator settings 1. Ventilator mode 2. Respiratory rate 3. Tidal volume or pressure settings 4. Inspiratory flow 5. I:E ratio 6. PEEP 7. FiO2 8. Inspiratory trigger CMV A/CV SIMV PSV(pressure support ventilation) Spontaneous inspiratory efforts trigger the ventilator to provide a variable flow of gas in order to attain a preset airway pressure. Can be used in adjunct with SIMV. Respiratory Rate 1. What is the pt actual rate demand? Tidal Volume or Pressure setting Maximum volume/pressure to achieve good ventilation and oxygenation without producing alveolar overdistention Max cc/kg? = 10 cc/kg Some clinical exceptions Inspiratory flow Varies with the Vt, I:E and RR Normally about 60 l/min Can be majored to 100- 120 l/min I:E Ratio 1:2 Prolonged at 1:3, 1:4, Inverse ratio FIO2 The usual goal is to use the minimum Fio2 required to have a PaO2 > 60mmhg or a sat >90% Start at 100% Oxygen toxicity normally with Fio2 >40% Inspiratory Trigger Normally set automatically 2 modes: Airway pressure Flow triggering Positive End-expiratory Pressure (PEEP) What is PEEP? What is the goal of PEEP? Improve oxygenation Diminish the work of breathing Different potential effects PEEP What are the secondary effects of PEEP?...
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Mechanical_Ventilation - MECHANICAL VENTILATION Marc...

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