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Ventilator Graphics

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Smruti Patanaik
Smruti Patanaik

www.medicotesting.com

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BASIC PRINCIPLES OF MECHANICAL VENTILATION ANDVENTILATOR GRAPHICS
BASIC PRINCIPLES OF MECHANICAL VENTILATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AIRWAY RESISTANCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONDITIONS LEADING TO AIRWAY RESISTANCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AIRWAY RESISTANCE AND WORK OF BREATHING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
LUNG COMPLIANCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LUNG COMPLIANCE CONT- ,[object Object],[object Object],[object Object],[object Object]
CLINICAL CONDITIONS THAT DECREASE THE COMPLIANCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIGH COMPLIANCE ,[object Object],[object Object]
VENTILATORY FAILURE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HYPOVENTILATION ,[object Object],[object Object],[object Object],[object Object]
VENTIATION PERFUSION MISMATCH ,[object Object],[object Object],[object Object],[object Object]
INTRAPULMONARY SHUNTING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIFFUSION DEFECT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Purpose of Graphics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of Waveforms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of Waveforms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of Waveforms Volume Modes Pressure Modes Volume Control/ SIMV (Vol. Control) Pressure Control/ PRVC SIMV (PRVC) SIMV (Press. Control) Pressure Support/ Volume Support Pressure Flow Volume Pressure Flow Volume
Pressure/Time Scalar ,[object Object],[object Object],[object Object],[object Object]
Pressure/Time Scalar ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can be used to assess:
Pressure/Time Scalar ,[object Object],[object Object],5 15 No patient effort Patient effort PEEP +5
Pressure/Time Scalar A B 1 2 Inspiratory pause = MAP 1 = Peak Inspiratory Pressure (PIP) 2 = Plateau Pressure (Pplat) A = Airway Resistance (Raw) B = Alveolar Distending Pressure ,[object Object]
Pressure/Time Scalar Increased Airway Resistance Decreased Compliance PIP Pplat PIP Pplat A . B . ,[object Object],[object Object],[object Object]
Volume/Time Scalar ,[object Object],[object Object]
Volume/Time Scalar ,[object Object],[object Object],[object Object],[object Object],[object Object],Can be used to assess:
Volume/Time Scalar Inspiratory Tidal Volume Exhaled volume returns to baseline
Volume/Time Scalar Air-Trapping or Leak ,[object Object],Loss of volume
Flow/Time Scalar ,[object Object],[object Object],[object Object],[object Object]
Flow/Time Scalar ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can be used to assess:
Flow/Time Scalar Volume Pressure
Flow/Time Scalar ,[object Object]
Flow/Time Scalar Auto-Peep (air trapping) ,[object Object],Start of next breath Expiratory flow doesn’t return to baseline = Normal
Flow/Time Scalar Bronchodilator Response ,[object Object],[object Object],Peak Exp. Flow Improved Peak Exp. Flow Shorter E-time Longer E-time Pre-Bronchodilator Post-Bronchodilator
Types of Waveforms Volume Modes Pressure Modes ,[object Object],[object Object],Volume Control/ SIMV (Vol. control) Pressure Control/ PRVC SIMV (PRVC) SIMV (Press. control) Pressure Support/ Volume Support Pressure Flow Volume Pressure Flow Volume
[object Object],[object Object],Types of Waveforms
Pressure/Volume Loops 15 30 5 250 500
Pressure/Volume Loops ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pressure/Volume Loops ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can be used to assess:
Pressure/Volume Loops inspiration expiration 15 30 5 Dynamic Compliance A A = Inspiratory Resistance/ Resistive WOB B ( Cdyn ) ,[object Object],[object Object],500 250 B = Exp. Resistance/ Elastic WOB
Pressure/Volume Loops 15 30 5 Overdistention “ beaking ” ,[object Object],[object Object],500 250
Pressure/Volume Loops 15 30 5 Airway Resistance ,[object Object],[object Object],“ hysteresis” exp. resistance insp. resistance 500 250
Pressure/Volume Loops 15 30 5 250 500 15 30 5 Increased Compliance Decreased Compliance Example: Emphysema, Surfactant Therapy Example: ARDS, CHF, Atelectasis 500 250
Pressure/Volume Loops 15 30 5 A Leak ,[object Object],500 250
Pressure/Volume Loops 15 30 5 Lower Inflection Point ,[object Object],[object Object],Inflection Points 250 500
Point of upper inflection (Ipu) ,[object Object],[object Object],[object Object]
Flow/Volume Loops 0 200 400 600 20 40 60 -20 -40 -60
Flow/Volume Loops ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Flow/Volume Loops ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can be used to assess:
Flow/Volume Loops 0 200 400 600 20 40 60 -20 -40 -60 PEF Start of Inspiration Start of Expiration
Flow/Volume Loops 0 0 ,[object Object]
DIFFERENT FLOW VOLUME LOOPS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Flow/Volume Loops 0 200 400 600 20 40 60 -20 -40 -60 Expiratory portion of loop does not return to starting point, indicating a leak. A Leak ,[object Object],= Normal
Flow/Volume Loops 0 0 Reduced PEF “ scooping” ,[object Object],[object Object],Airway Obstruction
Air Trapping (auto-PEEP) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Airway Resistance Changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Compliance Changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leaks ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Asynchrony ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Asynchrony Flow Starvation ,[object Object]
Asynchrony F/V Loop P/V Loop
Rise Time & Inspiratory Cycle Off %
Rise Time ,[object Object],[object Object],[object Object]
Rise Time ,[object Object],[object Object],too slow too fast pressure spike
Inspiratory Cycle Off ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inspiratory Cycle Off ,[object Object],Inspiration ends pressure flow
Inspiratory Cycle Off ,[object Object],100% of Patient’s Peak Inspiratory Flow Flow 100% 50% 30% 75%
Inspiratory Cycle Off ,[object Object],60% 10% ,[object Object],Exhalation spike A B 100% 100%
Sources: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thank You!

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