Assincronias Como abordar Interpretao das curvas CARMEN SILVIA

Assincronias: Como abordar. Interpretação das curvas CARMEN SILVIA VALENTE BARBAS

Marini JJ, Smith TC, Lambi VJ. External work output and force generation during syncronized intermitent mechanical ventilation. Effect of machine assistance on breathing effort. Am Rev Respir Dis 1988; 138: 1169 -1179.

Sassoon CSH. Intermitent Mandatory Ventilation. in Principles and Practice of Mechanical Ventilation, Mc Graw Hill, 1994: 221 -238.

Improved efficacy of spontaneous breathing with inspiratory pressure support. Brochard L, Pluskwa F, Lemaire F. Am Rev Respir Dis 1987, 136: 411 -5.

Barbas CSV, Amato MBP, Rodrigues Jr M. Técnicas de Assistência Ventilatória em CONDUTAS NO PACIENTE GRAVE, 1998: 321 -352.

Inspiratory Pressure Support prevents diaphragmatic fatigue during weaning from mechanical ventilation Brochard L, Harf A, Lorino H, Lemaire F. Am Rev Respir Dis 1989, 139: 513 -21.

Inspiratory Pressure Support Compensates for the Additional Work of breathing Caused by Endotracheal Tube. Brochard L, Rua F, Lorino H, Lemaire F, Harf A. Anesthesiology, 1991: 739 -74.

PRESSÃO SUPORTE: Palv PERSPECTIVAS Palv Ciclagem (Fluxo) Controle : Pressão Inclinação Ciclagem

UTI-RESPIRATÓRIA HC- FMUSP, 1991.

Amato MBP, Barbas CSV, Bonassa J; Saldiva PHN; Zin WA; Carvalho CRR Volume-assured pressure support ventilation (VAPSV). A new approach for reducing muscle workload during acute respiratory failure. Chest - 01 -Oct-1992; 102(4): 1225 -34

VAPSV: ventilação com pressão de suporte e volume garantido: ventilação que combina a pressão de suporte e ventilação ciclada a volume num mesmo ciclo respiratório. Amato MBP, Barbas CSV, Bonassa J; Saldiva PHN; Zin WA; Carvalho CRR Volume-assured pressure support ventilation (VAPSV). A new approach for reducing muscle workload during acute respiratory failure. Chest 01 -Oct-1992; 102(4): 1225 -34

Amato MBP, Barbas CSV, Bonassa J; Saldiva PHN; Zin WA; Carvalho CRR Volume-assured pressure support ventilation (VAPSV). A new approach for reducing muscle workload during acute respiratory failure. Chest - 01 -Oct-1992; 102(4): 1225 -34

Amato MBP, Barbas CSV, Bonassa J; Saldiva PHN; Zin WA; Carvalho CRR. Volume-assured pressure support ventilation (VAPSV). A new approach for reducing muscle workload during acute respiratory failure. Chest - 01 -Oct-1992; 102(4): 1225 -34

CLOSED-LOOP CONTROL MECHANICAL VENTILATION DUAL CONTROL MODES COMBINING VOLUME AND PRESSURE BREATHS Branson RD, Davis Jr K. Respir Care Clin N Am - 01 -Sep-2001; 7(3): 397 -408. Controle de pressão e volume em alça fechada durante o Mesmo ciclo respiratório: VAPSV: BIRD 8400 T-BIRD PA: Bear 1000.

Controle de pressão e volume em alça fechada durante o mesmo ciclo respiratório: VAPS: BIRD 8400 e T-BIRD PRESSURE AUGMENTATION: BEAR 1000

PATIENT-VENTILATOR ASYNCHRONY: 1. INEFFECTIVE TRIGGERING (90%) 2. AUTOTRIGGERING 3. DOUBLE TRIGGERING 4. PREMATURE CYCLE 5. DELAYED CYCLING

NAVA: É UM NOVO MODO VENTILATÓRIO AJUSTAD O ATRAVÉS DO DRIVE NEURAL.

NAVA:

NAVA VENTILATION-REVIEW Minerva Anesthesiol, 2010, 346 -52.

Caso 2: Paciente de 76 anos, tabagista grave , DPOC grave , obstrução grave, Auto-PEEP de 15 cm. H 20 Dessincronização na PSV

Proportional assist ventilation is a mode of partial ventilatory support in which the ventilator applies pressure in proportion to the patient’s inspiratory effort

% PAV-PLUS 5 to 95%

And in proportion to the patients respiratory mechanics (compliance and resistance)

PAV-PLUS

In the PS group, from a total of 696 measurements, 95 (13. 6%) revealed a difference between patients’ breathing frequency and ventilator rate. In the PAV+ group, from a total of 744 measurements, 21 (2. 8%) revealed a difference between patients’ breathing frequency and ventilator rate. PAV (744 measurements) Ventilator rate (cycles/min) PS (696 measurements) Patients breathing frequency (breaths/min) Xirouchaki et al. Intensive Care Med 2008

Assincronias: Como abordar. Interpretação das curvas CARMEN SILVIA VALENTE BARBAS