3.4.Conventional modes SIMV PSV PEEP, CPAP, IRV.ppt
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This document discusses various modes of mechanical ventilation including CMV, A/C, IMV, and SIMV. CMV provides full ventilatory support with no spontaneous breathing allowed. A/C allows patients to spontaneously breathe in addition to mandatory breaths. IMV delivers mandatory breaths on a timed cycle with spontaneous breathing allowed in between. SIMV improves on IMV by synchronizing mandatory breaths with patient effort to reduce asynchrony. SIMV has advantages over CMV like lower sedation needs and reduced risks of barotrauma and hemodynamic effects.
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This document discusses the role of mechanical ventilation in congenital heart disease. It begins by defining mechanical ventilation and its history. It then covers the goals, ideal design, and components of mechanical ventilation. Several sections discuss how mechanical ventilators work, including different modes, parameters, and the effect on the cardiovascular system. The document concludes by covering indications for mechanical ventilation in congenital heart disease and initial ventilator settings.
Mechanical ventilation
A primer on mechanical ventilation modes and uses. Targeted towards residents and nurse practitioners
Physics of Ventilation
by the renowned pediatrician, Dr Satish Deopujari,
National Chairperson (Ex)
Intensive Care Chapter I A P
Founder Chairman.....
National conference on pediatric critical care
Professor of pediatrics ( Hon ) JNMC:Wardha
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4.2-Mechanical-Ventilation-Part-II2.ppt
This document provides an overview of mechanical ventilation and weaning. It discusses the goals, indications, criteria for initiation, physiological effects, basic physics including equations of motion, compliance, distending pressure, and components of inflation pressure. Modes of ventilation like controlled mandatory ventilation, assist control, synchronized intermittent mandatory ventilation, pressure control ventilation, pressure support ventilation, and positive end expiratory pressure are explained. Factors affecting compliance and conditions decreasing compliance are also reviewed.
Mechanical ventilation modes 4nd elisa ventilation
The document discusses various ventilator modes and nomenclatures including:
1. Volume-controlled ventilation modes like VCV, PLV, and VC-SIMV as well as pressure-controlled modes like PCV.
2. Chatburn taxonomies from 2007 and 2014 that classify ventilation modes based on 10 fundamental maxims.
3. The S3 guideline nomenclature which classifies modes as controlled, supporting spontaneous breathing, adaptive, or special modes based on their control variables.
4. Examples of manufacturer modes that are comparable to the discussed nomenclatures.
VentilatorModesStudyGuide.pdf
Here are the key points about A/C mode:
- It provides full ventilatory support by delivering both mandatory and assisted breaths.
- It keeps the patient's work of breathing very low.
- A potential disadvantage is it can lead to hyperventilation if too many breaths are delivered.
Ventilator mode classification
1. A ventilator mode describes how the ventilator controls pressure (P), volume (V), and flow within each breath through a primary control variable (V, P, or dual) and how mandatory and spontaneous breaths are sequenced (CMV, IMV, CSV).
2. Control types describe the ventilator's feedback control and include tactical (within breath), strategic (between breaths), and intelligent (between patients) control.
3. Phase variables like trigger, limit, cycle, and baseline determine the beginning, sustaining and ending of each breath phase.
Weaning
This document discusses weaning patients from mechanical ventilation. It begins by describing the need for mechanical ventilation in critically ill patients and the indicators that it is needed. It then discusses the settings and modes of mechanical ventilation, including tidal volume, respiratory rate, pressure support, and others. Finally, it outlines the process of weaning patients from mechanical ventilation, including assessing readiness, using techniques like gradually reducing support on SIMV or pressure support, and conducting spontaneous breathing trials using a T-piece. It stresses evaluating gas exchange and respiratory status during weaning and being prepared for potential reintubation.
ventilator mode.pptx
This document provides an overview of various modes of mechanical ventilation. It begins by defining key terms like peak inspiratory pressure, plateau pressure, PEEP, and CPAP. It then describes the basic modes of ventilation: volume-controlled, pressure-controlled, and pressure support. Various advanced modes are also outlined such as SIMV, BiPAP, APRV, and ASV. Factors related to weaning a patient from mechanical ventilation are discussed. Throughout, details are provided on the objectives, physiology, advantages, and disadvantages of each ventilation mode.
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3.4.Conventional modes SIMV PSV PEEP, CPAP, IRV.ppt
- 2. Definition: Mode A mode is a specific combination of it’s variables (components). Flow Volume Pressure Time The Control Variables Flow
- 5. Continuous Mechanical Ventilation Controlled Mechanical Ventilation CMV Terminology = IPPV
- 6. Volume Controlled Ventilation PCV VCV Pressure Controlled Ventilation pressure time pressure time CMV
- 7. CMV All the work is done by the ventilator. The ventilator delivers a preset • Tidal Volume (VT) • Respiratory rate (f). a time-triggered mandatory breathes
- 8. CMV In CMV the patient can not breath Spontaneously. No gas flow is delivered between the mandatory breathes.
- 11. Patient triggering CMV + A/CV Pressure Flow A/CV
- 12. The A/C mode does Not allow the pt to breath Spontaneously in his own Vt. In A/C the pt may increase the R.R. (assist) in addition to the preset mechanical R.R. (control). Each assist breath provides the pt with the same preset VT. A/CV
- 14. A/CV INDICATIONS Used to provide full ventilatory support for the patients without fighting the ventilator as in CMV
- 15. Rapid breathing leads to Respiratory Alkalosis. A/CV Adverse effects: reduced Te leads to hyperinflation & auto PEEP
- 17. IMV mode was originally introduced as a technique for weaning from IPPV. IMV
- 18. IMV system allows “spontaneous” breathing between “mandatory” tidal volumes delivered by the ventilator. IMV
- 19. • Mandatory breaths: time-cycled • Spontaneous breath: Patient-cycled IMV
- 20. with IMV there is a Patient-Ventilator A-Synchrony. The mandatory breaths are not synchronized with the pt’s Spont. efforts
- 21. Synchronized Intermittent Mandatory Ventilation SIMV
- 22. The mandatory breathes of IMV is initiated by and synchronized with, patient effort. SIMV
- 23. It can provide partial ventilatory support. SIMV SIMV is now used as an alternative to conventional CMV A/C. It can provide complete ventilatory support. SIMV is weaning mode
- 24. A mandatory breaths are synchronized with the pt’s Spontaneous breathing. 3. Spontaneous breath 2. Assisted breaths: (patient-triggered) SIMV In SIMV there is 3 types of breathes 1. Mandatory breaths (time-triggered)
- 25. Trigger window pressure SIMV is the time interval just before to time-trigger in which the ventilator is responsive to the pt spontaneous inspiratory efort and gives assisted breath. Synchronization Window Triggering
- 26. SIMV allows the mech. breath to be delivered in response to patient’s insp. effort Time when cycling mechanism is activated Airway pressure cmH2O Time (sec.) Spon. Insp. effort SIMV
- 28. SIMV circuits Continuous flow circuit Demand flow valve
- 29. 1- SIMV continuous flow circuit
- 30. Advantage of SIMV over CMV 1- Decreased requirement for sedation and muscle relaxation. 2- Lower mean airway pressure: • Less cardiovascular depression. • Less risk of barotrauma. • Renal function is preserved. 3- Better matching of V/Q Reduces ventilation to perfusion (V/Q) mismatch.
- 31. 4- Easier weaning due to : • Prevention of respiratory muscle atrophy / discoordination. • No respiratory alkalosis.
- 32. During weaning, the mandatory ventilation is further decrease in number as the patient’s ability to increase his own spontaneous minute ventilation.