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Mechanical Ventilation PV Curves
Techniques for Measurement 1. Supersyringe 2. Constant Flow 3. Multiple Occlusion
Low Constant Flow Simple Can be performed on ventilator (some types) Avoids disconnect Hysteresis Heavy sedation or paralysis required Flow 9 L/min for “quasi-static” conditions 1 1 Qin Lu, AJRCCM 1999;159:275-282 Servillo, AJRCCM 1997;155:1629-1636
Radford, Tissue Elasticity, 1957 Surface forces due to air-liquid interface
Gattinoni, ARRD 1987;136:730-736 Pflex
P "safe" window zone of overdistension V Pressure-Volume Curve LIP UIP zone of derecruitment and atelectasis
PV Curve Normal ARDS COPD
P "safe" window zone of overdistension V atelectrauma volutrauma Lung Protective Ventilator Strategies LIP UIP zone of derecruitment and atelectasis DON’T EVEN THINK OF PARKING HERE
Pressure Volume Safe zone Overdistention Derecruited Lower P flex, LIP Upper P flex, UIP PV Curve in ARDS
Preventing Overdistention and Under-Recruitment Injury “Lung Protective” Ventilation VOLUMEVOLUME VOLUMEVOLUME Pressure Limit Distending Pressure Add PEEP Limit VT
PV Curve COPD
Pressure Volume Curve of the Respiratory System
“ فإذا سويته ونفخت فيه من روحي فقعوا له ساجدين“ ص ۷۲.
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Ventilator-Induced Lung Injury N Engl J Med 2013;369: Arthur S. Slutsky, M.D., and V. Marco Ranieri, M.D 호흡기 내과 / R4 이민혜 Review Article.
FEATURES: Pa O2 < 6O mm of Hg Pa Co2 – normal or low (< 50 mm Hg) Hydrogen Ion conc. - normal Bicarbonate ion conc. - normal.
Patrick Gleason MS4 University of South Carolina School of Medicine 1.
Mechanical Ventilation: The Basics and Beyond
1 Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 14 Respiratory Monitoring in the Intensive Care Unit.
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Date of download: 5/30/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Mechanical Breath Profile of Airway Pressure Release.
Basic Pulmonary Mechanics during Mechanical Ventilation
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