Special Procedure What is PEEP ? Positive End Expiratory Pressure Where does PEEP have a positive effect? Increased alveolar recruitment What could be.

Slides:

Advertisements

Similar presentations

Neonatal Mechanical Ventilation

Advertisements

Basics of Mechanical Ventilation

Pulmonary Mechanics and Graphics during Mechanical Ventilation

DAVID AYMOND, PGY-II Ventilator Principles and Management.

The Map Between Lung Mechanics and Tissue Oxygenation The Map Between Lung Mechanics and Tissue Oxygenation.

1 Pre-ICU Training CHEST Mechanical Ventilatory Support 2008/6/20.

Educational Resources

Wollongong CGD, October 31 Mechanical Ventilation.

Tutorial: Pulmonary Function--Dr. Bhutani Clinical Case 695 g male neonate with RDS, treated with surfactant and on ventilatory 18 hours age:

1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license.

3100B Theory of Operation and Controls. VIASYS Healthcare, Inc. 3100B Theory of Operation and Controls Approved for sale outside the US in 1998 for patients.

Troubleshooting and Problem Solving

Interpretation of Ventilator Graphics

3100A Ventilator. VIASYS Healthcare, Inc. 3100A Ventilator Approved in 1991 for Neonatal Application for the treatment of all forms of respiratory failure.

Initial Ventilator Settings

Pulmonary Volumes and Capacities—Spirometry A simple method for studying pulmonary ventilation is to record the volume movement of air into and out of.

Department of Critical Care Medicine Kovai Medical Center and Hospital.

Mechanical Ventilation. Epidemiology 28 day international study –361 ICUs in 20 countries –All consecutive adult patients who received MV for > 12 hours.

Objectives Discuss the principles of monitoring the respiratory system

SERVO-i VENTILATOR GRAPHICS

CMV Mode Workshop.

RC 210 Chapter 7 Lecture 1. Primary Goal Overall primary goal of mechanical ventilation is to meet the oxygen and carbon dioxide requirements for patients.

MECHANICAL VENTILATION

By: Susan P. Pilbeam, MS, RRT, FAARC John D. Hiser, MEd, RRT, FAARC

MECHANICAL VENTILATION

1 Elsevier items and derived items © 2010 by Saunders, an imprint of Elsevier Inc. Chapter 19 Mechanical Ventilation of the Neonate and Pediatric Patient.

Ventilators All you need to know is….

Without reference, identify principles about volume/pressure and high frequency ventilators with at least 70 percent accuracy.

Effect of different cycling off criteria and positive end-expiratory pressure during pressure support ventilation in patients with chronic obstructive.

How To Ventilate ICU Patient Dr Mohammed Bahzad MBBS.FRCPC,FCCP,FCCM Head Of Critical Care Department Mubarak Alkbeer Hospital.

3100B Theory of Operation and Controls. SensorMedics 3100B u Electrically powered, electronically controlled piston-diaphragm oscillator u Paw of 5 -

Neonatal Ventilation: “The Bivent”

Pandemic [H1N1] 2009 RT Education Module 2 Lung Protection.

Ventilator Graphics Chapter 10. Graphics Monitor the function of the ventilator Evaluate the patient’s response to the ventilator Help the clinician adjust.

Mechanical Ventilation Khaled Hadeli, M.D.. History.

Basic Concepts in Adult Mechanical Ventilation

These are measured with a spirometer This is estimated, based on

BASICS OF WAVEFORM INTERPRETATION Michael Haines, MPH, RRT-NPS, AE-C

Ventilator Graphics Emeritus Professor Georgia State University

Mechanical Ventilation 101

3 nd LECTURE VENTILATORS Part One. Ventilators One of the major life support systems. Ventilators take over the vital role of the respiratory muscles.

Mechanical Ventilation Graphical Assessment

Are You Optimizing Every Bilevel Breath? Jim Eddins, RRT.

Ventilatory Modes. Volume Controlled Mandatory Breath Gas is delivered at a constant flow until the set tidal volume is reached. Pressure rises to a.

Ventilatory Modes Graphnet Ventilator.

Principles of Mechanical Ventilation Mazen Kherallah, MD, FCCP.

NEW 3.0 SOFTWARE FOR SERVO-i AND SERVO-s Servo-i Ventilator

Principles of Mechanical Ventilation Mazen Kherallah, M.D., FCCP Internal Medicine, Critical Care Medicine, and Infectious Diseases Initial Ventilatory.

PRESSURE CONTROL VENTILATION

CLINICAL UTILITY OF VENTILATOR GRAPHICS

Principles of Mechanical Ventilation Magdy M Khalil, MD, EDIC Prof. Pulmonary& Critical Care Medicine.

Esophageal pressure measurements in a patient with auto–positive end-expiratory pressure (auto-PEEP). Note that an esophageal pressure decrease of approximately.

Mechanical Ventilation - Introduction

Introduction to Basic Waveforms

Ventilator waveform analysis: often ignored bedside assessment

Mechanical Ventilator 2

These are measured with a spirometer This is estimated, based on

Effects of PEEP on Respiratory Mechanics after Open Heart Surgery

Basic Concepts in Adult Mechanical Ventilation

The patient is being ventilated with 2 types of breaths.

Airway pressure and flow waveforms during constant flow volume control ventilation, illustrating the effect of an end-inspiratory breath-hold. Airway pressure.

Adjusting comfort settings on Newport HT70 Series Ventilators

Lung simulator diagram of airway pressure release ventilation (APRV): volume (yellow), lung pressure (white), and flow (orange)/time curve. Lung simulator.

Lung protective strategies in anaesthesia

New ventilators for the ICU—usefulness of lung performance reporting

A–f) Respiratory mechanical measurements during incremental cycle exercise in patients with moderate chronic obstructive pulmonary disease (COPD) and age-matched.

A) Pressure–time and b) flow–time waveforms in the panel of ventilator Astral 150 (ResMed, Bella Vista, Australia). a) The expiratory flow curve does not.

Pumping up the Pressure

Determinants of patient-ventilator interaction.

Depiction of an expiratory flow curve.

Presentation transcript:

Special Procedure What is PEEP ? Positive End Expiratory Pressure Where does PEEP have a positive effect? Increased alveolar recruitment What could be compromised with PEEP? Poor venous return Negative influence on heart What is PEEPi ? Intrinsic PEEP A measurement, in pressure, of trapped volume in lungs High PEEPi is a result of patient illness and patient/ventilator interaction

Trapped Volume During Mandatory Ventilation Time (I : E ratio) Insp. time - must be adequate for delivery of desired V TI Exp. time - must be long enough to eliminate V TE Insufficient expiratory time means trapped volume

PEEP i = Auto PEEP = Alveolar PEEP Lung status information available in every mode Auto stop of measurements if pressure increases (mes. time 1) or flow becomes zero (mes. time 2) Maximum measuring times for paediatric and adults PEEPiadultmax.3 s paediatricmax.1.5 s V Trap adultmax. 7 s paediatricmax.3.5 s Improved monitoring of inverse ratio ventilation (IRV) PEEPi

Heart and Lung poor Compliance contributes to poor gas exchange pressure is in the lungs pressure is in the heart They work against each other. PEEPi increases pressure against the heart.

Where Does Measurement of PEEPi Take Us? Safer ventilation Improved alveolar recruitment Improved ventilation comfort for asthmatics and COPD patients