Weaning from ventilatory support lobitoferoz13
•Transferir como PPT, PDF•
3 gostaram•1,854 visualizações
Recomendados
Mais conteúdo relacionado
Mais procurados
Mais procurados (20)
Semelhante a Weaning from ventilatory support lobitoferoz13
Semelhante a Weaning from ventilatory support lobitoferoz13 (20)
Mais de universidad san marcos
Mais de universidad san marcos (20)
Último
Último (20)
Weaning from ventilatory support lobitoferoz13
- 1. WEANING FROM VENTILATORY SUPPORT ALLAN PEPE VASQUEZ TEJADA Medico Residente de Cirugía. HVLE 2010
- 2. CaO2 CvO2 DO2 O2R VO2 Transportamos Consumimos Extraemos
- 11. FLUJO DE AIRE
- 12. DISTENSIBILIDAD La misma presión disminuye el volumen La presión en aumento mantiene el volumen Distensibilidad = dV/dP = Vt Pi max - PEEP
- 16. Alvéolos
- 17. Inspiración Presión Intrapleural: - 8 cmH20 Fase Activa
- 18. Espiración Fase Pasiva Presión Intrapleural: - 5 cm H20
- 19. DIFERENCIA REGIONAL DE LAVENTILACION 100% 50% 0 + 10 0 - 10 - 20 - 30 PRESION INTRAPLEURAL VOLUMEN - 10 cm H2O - 2.5 cm H2O LA BASE PULMONAR ESTA RELATIVAMENTE COMPRIMIDA EN REPOSO PERO EXPANDE MEJOR EN INSPIRACION QUE EL APEX
- 21. Volúmenes y Capacidades Capacidad Pulmonar Total (5800 ml) Capacidad vital (4600 ml) Volumen residual (1200 ml Capacidad Inspiratoria (3500 ml) Capacidad Funcional Residual (2300 ml) Volumen de reserva inspiratoria (3000 ml) Volumen Corriente 450-550 ml Volumen de reserva espiratoria (1100 ml) Volumen residual (1200 ml)
- 23. 02 OXIGENACION Pi02 Fi02 x (PB - 47) Pi02 0.21 x (760 -47) 0.21 x 713 150 mm Hg Ley de Dalton
- 24. Pi02 OXIGENACION PA02 150 mmHg 105 mmHg
- 27. Curva Disociación Oxi Hb Sat 02 90 60 PaO2 50 26 mmHg 100
- 28. INTERCAMBIO GASEOSO Pv02 Pa02 Pi 02 150 mmHG ALVEOLO PA02 105 mmHG 100 mmHG 45 mmHG
- 30. (Hb) (1.39) (Sat 02 Hb) Ca02 = ------------------------------ +(Pa02) (0.003) 100 Contenido arterial de 02 Ca02 Hb Sat O2 Hb O2 Disuelto 20 ml
- 40. Respiracion Espontanea P aw (cm H 2 0) Tiempo (seg) Inspiracion Espiracion
- 41. Espontanea vs Mecanica Mecanica Tiempo (seg) Espontanea P aw (cm H 2 O) Inspiracion Espiracion Espiracion Inspiracion
- 42. CMV A/C SIMV CPAP Tiempo 0 0 0 0 SOPORTE TOTAL SOPORTE VENTILATORIO PARCIAL ESPONTANEO
- 43. Asistida vs Controlada Tiempo (seg ) Asistida Controlada Presion (cmH 2 0) Esfuerzo del Paciente
- 44. PCV vs. VCV P Se regula la P inspiratoria máxima y el tiempo Inspiratorio Se regula el Vt y el flujo
- 45. SIMV (Ventilacion Mandatoria Intermitente Sincronizada) Respiracion Espontanea Flujo Presion (cm H 2 O) Volumen (mL)
- 46. CPAP Presion Positiva Continua en la Via Aerea Tiempo (seg) Flujo (L/m ) Presion (cm H 2 O) Volumen (mL) Nivel de CPAP
- 56. GRACIAS
Notas do Editor
- 26 Here, we can see the pressure and flow time waveforms for different I-times. As the inspiratory time increases, the positive pressure is delivered and then held in the patient’s lung for a longer period of time. Let’s take a look at the advantages and disadvantages of pressure based ventilation.
- 27 17 One advantage of pressure control ventilation is a decreased risk of barotrauma caused by over distention. Also, the medical community as a whole is focused on minimizing the pressure the lung is exposed to. Longer inspiratory time may recruit collapsed and flooded alveoli and improve gas distribution. One disadvantages is that tidal volumes vary when patient compliance changes, such as with the ARDS or pulmonary edema patient. Setting a low tidal volume alarm or minute volume alarm can alert the clinician to this changing status, and the patient can be re-evaluated. Another issue that arises with increases in inspiratory time, is that the patient may require heavy sedation or chemical paralysis. Newer ventilators on the market incorporate an active exhalation valve that allows the patient to breath spontaneously during the set inspiratory time in pressure control ventilation. It will remain to be seen whether a decrease in paralysis may be the result of this active valve.