VENTILATION 101 Junior Practitioner Learning Package Dr Bronwyn

VENTILATION ‘ 101’ Junior Practitioner Learning Package Dr Bronwyn Avard, July 2010

Objectives To understand the physiological principles underlying mechanical ventilation To know the different terminology associated with mechanical ventilation

PRE-TEST Please complete pre-test before proceeding with learning package http: //www. surveymonkey. com/s/ventilation_juniorpack_pretest

BASIC RESPIRATORY PHYSIOLOGY

POSITIVE PRESSURE VENTILATION

TERMINOLOGY NIV IRV PEEP PS CPAP BIPAP SIMV

Invasive v Noninvasive INVASIVE VENTILATION NON-INVASIVE VENTILATION

Invasive v Noninvasive INVASIVE VENTILATION NON-INVASIVE VENTILATION CPAP BIPAP 10 cm. H 2 O PRESSURE 5 cm. H 2 O TIME

Invasive v Noninvasive NON-INVASIVE VENTILATION controlled spontaneous volume control pressure support (SIMV) (PCV) (PS)

Invasive v Noninvasive INVASIVE VENTILATION pressure controlled (PCV) volume spontaneous (PS) controlled (SIMV) NON-INVASIVE VENTILATION

Invasive ventilation Volume-control ventilation VOLUME TIME

Invasive ventilation Volume-control ventilation - SIMV VOLUME TIME

Invasive ventilation Pressure-control ventilation PRESSURE TIME

PEEP 10 cm. H 2 O PRESSURE 5 cm. H 2 O TIME

Number tricks SET : pressure support 10 cm. H 20 & PEEP 5 cm. H 2 O Peak inspiratory pressure 15 cm. H 2 O Pressure = 10 cm. H 2 O PRESSURE 5 cm. H 2 O TIME PRESSURE SUPPORT

Number tricks SET : pressure support 10 cm. H 20 & PEEP 5 cm. H 2 O 20 cm. H 2 O Pressure = 10 cm. H 2 O TIME PRESSURE SUPPORT

Number tricks SET : PIP 15 cm. H 20 & PEEP 5 cm. H 2 O 15 cm. H 2 O Pressure = 10 cm. H 2 O PRESSURE 5 cm. H 2 O TIME PRESSURE CONTROL

Number tricks SET : PIP 15 cm. H 20 & PEEP 10 cm. H 2 O 15 cm. H 2 O Pressure = 5 cm. H 2 O PRESSURE 5 cm. H 2 O TIME PRESSURE CONTROL

Number tricks SET : IPAP 15 cm. H 20 & EPAP 5 cm. H 2 O 15 cm. H 2 O Pressure = 10 cm. H 2 O PRESSURE 5 cm. H 2 O TIME Bi. PAP

Number tricks SET : IPAP 15 cm. H 20 & EPAP 10 cm. H 2 O 15 cm. H 2 O Pressure = 5 cm. H 2 O PRESSURE 5 cm. H 2 O TIME Bi. PAP

Other issues Triggering Inspiratory time I: E ratios

Other issues Triggering Flow or pressure change Inspiratory time I: E ratio

Other issues Triggering Inspiratory time Default 1. 7 seconds Often reduced (1. 2 seconds more comfortable) I: E ratio

Other issues Triggering Inspiratory time I: E ratio Usually ~1: 3 When adjusting inspiratory time check I: E ratio Check not accidently ventilating with inspiratory time longer than expiratory time Disease-specific

Oxygen or Carbon Dioxide? Oxygenation Fi. O 2 PEEP Carbon dioxide Respiratory rate Pressure/volume

POST-TEST http: //www. surveymonkey. com/s/ventilation_juniorpack_posttest

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