Indication Indication Respiratory failure n To decrease or

Indication

Indication Respiratory failure n To decrease or support work of breathing n To improve oxygenation n To recruit the lung n To support other organs e. g. : increased ICP, CHF n

Normal value Tidal volume 10 -12 ml/kg in general or 6 -8 ml/kg in ARDS n MV 200 -300 ml /kg n

Parts and Humidifiers

How to set in some situations post-operative n asthma or BPD n pneumonia or ARDS n increased ICP n

Example 1 - post operative Mode: Pressure controlled ventilation PIP 20 cm H 2 O PEEP 5 cm H 2 O Fi. O 2 0. 5 i Time 1. 0 sec Rate 20 / min

Example 2 - asthma Mode: Time cycled pressure limited Flow 3 times minute ventilation (Normal MV = 200 -300 ml/kg) PIP 20 cm H 2 O PEEP 3 cm H 2 O Fi. O 2 0. 5 i Time 0. 6 sec Rate 20 / min

Alarms

Alarms Usually will set 15% more or less n MV 200 -300 ml /kg n Tidal volume 10 -12 ml/kg in general or 6 -8 ml/kg in ARDS n

Alarms n Pressure alarm for SIMV or volume mode n Expired TV alarm and MV alarm for Pressure mode n Apnea alarm or high RR alarm

Noninvasive mechanical ventiation

High frequency mechanical ventilation

Indication. 1 To serve as a ventilation mode when conventional ventilation has failed. . 2 To provide a mode of ventilation that minimizes barotrauma, or damage, to the delicate tissue in the lungs.

Pediatric Indications n n n n Neonatal Respiratory Distress Syndrome Persistent Pulmonary Hypertension Neonatal Meconium Aspiration Syndrome Congenital Diaphragmatic Hernia Neonatal Lung Hypoplasia Neonatal Air Leak Syndrome Pediatric ARDS/Pulmonary Interstitial Edema RSV Pneumonia

Monitoring

BP NIBP/IBP

CXR

End-tidal CO 2

Bedside pulmonary mechanics

Weaning

Weaning C- Consciousness n A- Airway n L- Lung n M- Muscle strength n

Patient Ventilator In coordination (Fight) Ventilator Malfunction n Inappropriate setting Under or Over of Trigger sensitivity Under or Over of Peak flow Under or Over of inspiratory time Inadequate Tidal volume n