Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

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Presentation transcript:

Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University

Types of mechanical ventilation Modes of mechanical ventilation Initial settings - full ventilatory support Weaning Extubation Ventilator Settings in Pediatric Patients

Volume control ventilator Pressure control ventilator Infant Ventilator Types of mechanical ventilation

Volume control ventilator V P V

V P V Pressure control ventilator

Infant Ventilator - Time cycle, pressure limit V P V 20

Which Type?

Expiratory to inspiratory phase Inspiratory phase Inspiratory to expiratory phase Expiratory phase Phases of mechanical ventilation

Control Assist/Contr ol IMV/SIMV PSV CPAP Modes of mechanical ventilation

Cont rol P 360

Modes of mechanical ventilation Assist/C ontrol P 360

Modes of mechanical ventilation IM V P 360

ITP -> venous return -> CO -> LV afterload Aware hyperinflation:Lowest PEEP, Optimal Te, Optimal PIP WOB: flow pattern, trigger Detrimental hemodynamic effects

Type Mode Flow Tidal volume T I Initial settings Rate FiO 2 PIP PEEP Trigge r

Type - Volume control Mode - A/C Flow Tidal volume T I Initial settings Rate FiO 2 PIP PEEP Trigge r 5-10 ml/kg sec

Type - Pressure control Mode - A/C Flow Tidal volume T I Initial settings Rate FiO 2 PIP PEEP Trigge r

Type - Infant ventilator Mode - A/C, IMV Flow Tidal volume T I Initial settings Rate FiO 2 PIP PEEP Trigge r sec

Oxygen ation Ventilati on Aims Tidal volume T I Rate FiO 2 PIP PEEP

Oxygen ation Ventilati on Aims Tidal volume T I Rate FiO 2 PIP PEEP

Modes IMV PSV CPAP T-tube Weanin g Tidal volume T I Rate FiO 2 PIP PEEP

Extubatio n CALM S Conscious Airway Lung Muscle Secretion SIMV 5-8 PS 5-10 FiO 2 < 0.4 PEEP < 5

Types of mechanical ventilation Modes of mechanical ventilation Initial settings - full ventilatory support Weaning Extubation Ventilator Settings in Pediatric Patients

Acute lung injury Oxygen toxicity Volutrauma Shear stress