Indication Indication Respiratory failure n To decrease or
- Slides: 46
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
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