This document discusses mechanical ventilation and provides guidelines on its use. It begins with definitions of hypoxemia and hypercarbia and their clinical indications. It then lists various indications for mechanical ventilation related to oxygen delivery and consumption imbalance, increased work of breathing, inspiratory muscle weakness, and heart failure. The document discusses the history of mechanical ventilation and some basic concepts including pressures, volumes, flows, compliance and resistance. It provides details on ventilator circuits, triggers, and phases of mechanical ventilation.
This document provides an overview of mechanical ventilation including:
- The basic components and goals of mechanical ventilators.
- Different modes of ventilation such as controlled, assisted, and pressure support ventilation.
- Parameters for setting up and monitoring ventilation like tidal volume, PEEP, and blood gases.
- Indications for initiating and weaning from ventilation.
- Potential complications and ways to troubleshoot issues with the ventilator or patient ventilation.
This document discusses mechanical ventilation and its physiology. It covers the main functions of the lungs related to gas exchange, oxygen diffusion pathways, and factors that determine oxygen diffusion. It then introduces mechanical ventilation, its aims, categories of invasive and non-invasive ventilation, and types of ventilators including conventional and high frequency ventilators. Various ventilation modes, controls, indications, and examples of negative pressure and positive pressure ventilation are also summarized.
This presentation deals with the basic physics of human ventillation. I have made an effort to clarify most of the venti lingo , so as to make way for further discussions on ventilator use. Hope it turns out to be helpful for you. Thank you.
1) The document discusses various aspects of mechanical ventilation including its history, classification, parameters, modes, and complications.
2) Key aspects covered include negative pressure ventilation devices like iron lungs, classification of ventilators based on pressure support, important parameters like compliance and resistance, and modes of ventilation including controlled, assisted, and spontaneous modes.
3) Complications of mechanical ventilation discussed are barotrauma, increased lung water, reduced cardiac output, and organ perfusion issues related to high airway pressures.
The document provides an overview of mechanical ventilation, including its objectives, indications, goals, and basic physics. It discusses normal respiration physiology and how positive pressure ventilation works. The major sections cover definitions of key terms, the anatomy and workings of ICU ventilators, physiology of positive pressure ventilation, and modes of ventilation. Modes discussed include volume control, pressure control, time-cycled, and combination modes.
MECHANICAL VENTILATION-SOME OF THE BASICS.pptxAjilAntony10
This document discusses mechanical ventilation, including its history, uses, types, settings, modes, complications, and patient care goals. It provides an overview of mechanical ventilation, describing how it works to mechanically assist or replace spontaneous breathing. Various modes of ventilation are outlined, along with typical settings adjusted based on patient status. Potential complications are listed. Patient goals focus on effective breathing, gas exchange, nutrition, preventing infection or immobility issues. Care includes airway management and monitoring respiratory rate and depth.
Mechanical ventilation is the use of a ventilator to move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. There are two main types: invasive ventilation which requires intubation, and non-invasive ventilation without intubation. The goals are to improve gas exchange, relieve respiratory distress, and improve pulmonary mechanics. Common modes include volume-controlled, pressure-controlled, and non-invasive BiPAP. Nurses monitor various parameters and alarms to assess patient-ventilator synchrony and make appropriate adjustments.
This document discusses the physiology of positive pressure ventilation. It covers:
- The goals and types of mechanical ventilation including positive and negative pressure ventilation.
- Key concepts including pressure gradients, time constants, airway pressures, and the effects of PEEP.
- How mechanical ventilation supports gas exchange and manipulates work of breathing while minimizing cardiovascular effects.
- Different pressure, volume, and flow waveforms and how they impact ventilation.
- Common ventilator modes like volume control, pressure control, and how they are classified based on triggers, limits, and cycling variables.
This document provides an overview of mechanical ventilation including:
- The basic components and goals of mechanical ventilators.
- Different modes of ventilation such as controlled, assisted, and pressure support ventilation.
- Parameters for setting up and monitoring ventilation like tidal volume, PEEP, and blood gases.
- Indications for initiating and weaning from ventilation.
- Potential complications and ways to troubleshoot issues with the ventilator or patient ventilation.
This document discusses mechanical ventilation and its physiology. It covers the main functions of the lungs related to gas exchange, oxygen diffusion pathways, and factors that determine oxygen diffusion. It then introduces mechanical ventilation, its aims, categories of invasive and non-invasive ventilation, and types of ventilators including conventional and high frequency ventilators. Various ventilation modes, controls, indications, and examples of negative pressure and positive pressure ventilation are also summarized.
This presentation deals with the basic physics of human ventillation. I have made an effort to clarify most of the venti lingo , so as to make way for further discussions on ventilator use. Hope it turns out to be helpful for you. Thank you.
1) The document discusses various aspects of mechanical ventilation including its history, classification, parameters, modes, and complications.
2) Key aspects covered include negative pressure ventilation devices like iron lungs, classification of ventilators based on pressure support, important parameters like compliance and resistance, and modes of ventilation including controlled, assisted, and spontaneous modes.
3) Complications of mechanical ventilation discussed are barotrauma, increased lung water, reduced cardiac output, and organ perfusion issues related to high airway pressures.
The document provides an overview of mechanical ventilation, including its objectives, indications, goals, and basic physics. It discusses normal respiration physiology and how positive pressure ventilation works. The major sections cover definitions of key terms, the anatomy and workings of ICU ventilators, physiology of positive pressure ventilation, and modes of ventilation. Modes discussed include volume control, pressure control, time-cycled, and combination modes.
MECHANICAL VENTILATION-SOME OF THE BASICS.pptxAjilAntony10
This document discusses mechanical ventilation, including its history, uses, types, settings, modes, complications, and patient care goals. It provides an overview of mechanical ventilation, describing how it works to mechanically assist or replace spontaneous breathing. Various modes of ventilation are outlined, along with typical settings adjusted based on patient status. Potential complications are listed. Patient goals focus on effective breathing, gas exchange, nutrition, preventing infection or immobility issues. Care includes airway management and monitoring respiratory rate and depth.
Mechanical ventilation is the use of a ventilator to move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. There are two main types: invasive ventilation which requires intubation, and non-invasive ventilation without intubation. The goals are to improve gas exchange, relieve respiratory distress, and improve pulmonary mechanics. Common modes include volume-controlled, pressure-controlled, and non-invasive BiPAP. Nurses monitor various parameters and alarms to assess patient-ventilator synchrony and make appropriate adjustments.
This document discusses the physiology of positive pressure ventilation. It covers:
- The goals and types of mechanical ventilation including positive and negative pressure ventilation.
- Key concepts including pressure gradients, time constants, airway pressures, and the effects of PEEP.
- How mechanical ventilation supports gas exchange and manipulates work of breathing while minimizing cardiovascular effects.
- Different pressure, volume, and flow waveforms and how they impact ventilation.
- Common ventilator modes like volume control, pressure control, and how they are classified based on triggers, limits, and cycling variables.
This document discusses the physiology of positive pressure ventilation. It covers:
- The goals and types of mechanical ventilation including positive and negative pressure ventilation.
- Key concepts including pressure gradients, time constants, airway pressures, and the effects of PEEP.
- Modes of ventilation including volume-controlled, pressure-controlled, and how they differ in terms of triggers, limits, and cycling.
- Waveforms including pressure, volume, and flow and how they are used to assess ventilation.
The document provides an overview of the fundamental physics and physiology principles underlying mechanical ventilation.
This document provides information about ventilation and mechanical ventilation. It defines ventilation as the process of moving air in and out of the lungs for gas exchange. Mechanical ventilation is the use of a device to provide artificial breathing when a patient cannot maintain adequate oxygen and carbon dioxide levels on their own. The document discusses the mechanics of normal breathing and ventilation, as well as the components, controls, phases and physiological principles of mechanical ventilation. It provides indications for mechanical ventilation and factors that affect ventilation such as lung compliance, airway resistance, and work of breathing.
Applied respiratory physiology for Anaesthesiologist.pptxSami Rehman
This document provides an overview of applied respiratory physiology, including:
- The functional anatomy of the respiratory system and associated structures.
- Respiratory mechanics such as lung volumes, compliance, resistance, and work of breathing.
- The distribution of ventilation and perfusion in the lungs, as well as the concepts of dead space, V/Q matching, and alveolar-arterial oxygen difference.
- The control of respiration by central and peripheral chemoreceptors in response to changes in gases such as oxygen and carbon dioxide.
The document compares mechanical ventilation strategies for acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD). For ARDS, the strategies aim to prevent volutrauma and barotrauma by limiting tidal volumes and airway pressures. Positive end-expiratory pressure (PEEP) is used to recruit alveoli and keep airways open. For COPD, the goal is to increase oxygen levels while allowing longer expiration to prevent auto-PEEP. Non-invasive ventilation can help both conditions but invasive ventilation may be needed for severe COPD exacerbations or if non-invasive methods fail.
The document provides an overview of mechanical ventilation, including indications for intubation and ventilation, principles of mechanical ventilation, patterns of assisted ventilation, ventilator dependence and complications, liberation from mechanical ventilation through weaning, and troubleshooting arterial blood gases. Key topics covered include indications for intubation, objectives of mechanical ventilation, strategies for mechanical ventilation including use of airway pressures and compliance, patterns of assisted ventilation such as assist control ventilation and pressure control ventilation, complications of mechanical ventilation, parameters for bedside weaning, and low volume ventilation strategies for ARDS.
MECHANICAL VENTILATION - A BRIEF DISCUSSION.pptxAjilAntony10
This document discusses mechanical ventilation, including its history, uses, types, settings, modes of ventilation, complications, and patient goals and care. It provides an overview of mechanical ventilation, from its use in acute and chronic illness to manage breathing, to different ventilator modes like CMV, ACV, SIMV and PSV. It also covers settings, interfaces, potential complications and how to monitor patients on ventilators.
The document discusses mechanical ventilation, including types, indications, principles, terminology, and modes. It describes noninvasive mechanical ventilation using external devices like masks, and invasive mechanical ventilation using endotracheal tubes. Common indications for mechanical ventilation include low oxygen levels, severe shortness of breath, and coma. The goals of ventilation are to facilitate carbon dioxide release and maintain normal oxygen levels in the blood. Various modes aim to individualize treatment based on a patient's needs, including controlled, supported, combined, and spontaneous breathing modes.
The document provides information on indications for mechanical ventilation, criteria for instituting ventilation based on pulmonary function and blood gas parameters, settings for mechanical ventilation including tidal volume, respiratory rate, PEEP, and oxygen concentration. It also outlines the basics of various ventilator modes including assist-control, pressure support, and SIMV. Guidelines are provided for initiating mechanical ventilation and troubleshooting issues like high pressures, low volumes, and patient-ventilator dysynchrony. The nurse's key roles in monitoring the patient and equipment are also summarized.
Modern ventilators use electromagnetic valves and microprocessors to control gas flow. They monitor factors like fractional inspired oxygen (FiO2), tidal volume, minute volume, respiratory rate, inspiratory/expiratory ratio, positive end expiratory pressure (PEEP), auto-PEEP, peak airway pressure, plateau pressure, resistance, compliance, recruitment, weaning, and anatomic dead space to ensure accurate ventilation and oxygen delivery to patients. Key settings and measurements include tidal volume of 6-8 ml/kg of ideal body weight, PEEP which improves gas exchange by recruiting alveoli, and plateau pressure which is generally 10-15 cm H2O less than peak pressure.
This document provides an overview of mechanical ventilation basics, including key terminology, oxygenation, ventilation, and basic modes of ventilation. It defines common terms like FiO2, PIP, PEEP, tidal volume, and rate. It explains that oxygenation depends on factors like MAP, FiO2, PIP, PEEP, I:E ratio, and flow rate. Ventilation depends on tidal volume, PIP, PEEP, and rate. The basic modes of ventilation - IMV, SIMV, AC, and PSV - vary based on whether the trigger, cycle, and rate are controlled by the ventilator or patient.
This document discusses ventilation in obstructive airway diseases. It provides indications and contraindications for non-invasive ventilation (NIV) including criteria such as respiratory rate greater than 25 breaths per minute and moderate to severe respiratory acidosis. NIV can be used to support patients with acute exacerbations of COPD or asthma to reverse respiratory failure. Ventilator settings aim to support gas exchange, reduce work of breathing, and prevent complications. Dynamic hyperinflation can cause auto-PEEP which increases workload and impairs hemodynamics. Settings to treat auto-PEEP include increasing expiratory time, reducing tidal volume, and applying external PEEP.
Mechanical ventilation involves using a ventilator to mechanically move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. It has several purposes including improving gas exchange, relieving respiratory distress, and avoiding complications. There are various modes of ventilation including pressure control, volume control, and time-cycled modes. Parameters like tidal volume, respiratory rate, and PEEP must be set and monitored appropriately for different patients and conditions.
Basic concepts in neonatal ventilation - Safe ventilation of neonatemohamed osama hussein
Lecture by by dr Muhammad Ezzat Abdel-Shafy MB.BCh, M.Sc Pediatrics Neonatology Sp. , Benha Children Hospital, provided during our Doctors neonatology workshop, 20th of January 2017
Mechanical ventilation involves using external equipment to control a patient's breathing. It can be invasive (using an endotracheal or tracheostomy tube) or non-invasive. Ventilators measure pressures, volumes, and gas exchange to carefully regulate a patient's ventilation. Settings like tidal volume, PEEP, and inspiratory time must be tailored to the individual patient's condition and needs. The goal is to provide adequate oxygenation and ventilation while avoiding potential harms like barotrauma or volutrauma.
The document provides information about acute respiratory distress syndrome (ARDS). It begins with a brief history of ARDS and provides the clinical definition. It describes the diagnostic criteria and etiology, including that most cases are caused by sepsis, pneumonia, or trauma. It then discusses the normal lung physiology and pathophysiology of ARDS, which involves three phases: exudative, proliferative, and fibrotic. The management section outlines the principles of therapy to provide adequate gas exchange while avoiding secondary injury, including mechanical ventilation protocols, fluid management, and other strategies. It concludes with a discussion of prognosis and recent advances in ARDS management such as protective ventilation strategies.
The document discusses basic principles of mechanical ventilation including factors that can lead to ventilatory failure, airway resistance, lung compliance, hypoventilation, V/Q mismatch, intrapulmonary shunting, and diffusion defects. It also covers different types of ventilator waveforms including pressure, volume, flow and pressure/volume loops which can be used to assess a patient's respiratory status and response to therapy.
This document discusses various physiological concepts related to respiration and mechanical ventilation. It covers topics such as:
- The equation of motion that describes pressure, flow, volume, and resistance during respiration.
- Components of respiratory system mechanics including compliance, resistance, inertance, and their relationships to pressure and volume changes.
- Physiological properties of the lung including surfactant function, pressure-volume curves, and the effects of lung volume on pulmonary vascular resistance.
- Principles of mechanical ventilation including how ventilator settings impact gas exchange, lung volumes, mean airway pressure, and the risks of ventilator-induced lung injury from barotrauma, volutrauma, and atelectra
This presentation is about Food Delivery Systems and how they are developed using the Software Development Life Cycle (SDLC) and other methods. It explains the steps involved in creating a food delivery app, from planning and designing to testing and launching. The slide also covers different tools and technologies used to make these systems work efficiently.
This document discusses the physiology of positive pressure ventilation. It covers:
- The goals and types of mechanical ventilation including positive and negative pressure ventilation.
- Key concepts including pressure gradients, time constants, airway pressures, and the effects of PEEP.
- Modes of ventilation including volume-controlled, pressure-controlled, and how they differ in terms of triggers, limits, and cycling.
- Waveforms including pressure, volume, and flow and how they are used to assess ventilation.
The document provides an overview of the fundamental physics and physiology principles underlying mechanical ventilation.
This document provides information about ventilation and mechanical ventilation. It defines ventilation as the process of moving air in and out of the lungs for gas exchange. Mechanical ventilation is the use of a device to provide artificial breathing when a patient cannot maintain adequate oxygen and carbon dioxide levels on their own. The document discusses the mechanics of normal breathing and ventilation, as well as the components, controls, phases and physiological principles of mechanical ventilation. It provides indications for mechanical ventilation and factors that affect ventilation such as lung compliance, airway resistance, and work of breathing.
Applied respiratory physiology for Anaesthesiologist.pptxSami Rehman
This document provides an overview of applied respiratory physiology, including:
- The functional anatomy of the respiratory system and associated structures.
- Respiratory mechanics such as lung volumes, compliance, resistance, and work of breathing.
- The distribution of ventilation and perfusion in the lungs, as well as the concepts of dead space, V/Q matching, and alveolar-arterial oxygen difference.
- The control of respiration by central and peripheral chemoreceptors in response to changes in gases such as oxygen and carbon dioxide.
The document compares mechanical ventilation strategies for acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD). For ARDS, the strategies aim to prevent volutrauma and barotrauma by limiting tidal volumes and airway pressures. Positive end-expiratory pressure (PEEP) is used to recruit alveoli and keep airways open. For COPD, the goal is to increase oxygen levels while allowing longer expiration to prevent auto-PEEP. Non-invasive ventilation can help both conditions but invasive ventilation may be needed for severe COPD exacerbations or if non-invasive methods fail.
The document provides an overview of mechanical ventilation, including indications for intubation and ventilation, principles of mechanical ventilation, patterns of assisted ventilation, ventilator dependence and complications, liberation from mechanical ventilation through weaning, and troubleshooting arterial blood gases. Key topics covered include indications for intubation, objectives of mechanical ventilation, strategies for mechanical ventilation including use of airway pressures and compliance, patterns of assisted ventilation such as assist control ventilation and pressure control ventilation, complications of mechanical ventilation, parameters for bedside weaning, and low volume ventilation strategies for ARDS.
MECHANICAL VENTILATION - A BRIEF DISCUSSION.pptxAjilAntony10
This document discusses mechanical ventilation, including its history, uses, types, settings, modes of ventilation, complications, and patient goals and care. It provides an overview of mechanical ventilation, from its use in acute and chronic illness to manage breathing, to different ventilator modes like CMV, ACV, SIMV and PSV. It also covers settings, interfaces, potential complications and how to monitor patients on ventilators.
The document discusses mechanical ventilation, including types, indications, principles, terminology, and modes. It describes noninvasive mechanical ventilation using external devices like masks, and invasive mechanical ventilation using endotracheal tubes. Common indications for mechanical ventilation include low oxygen levels, severe shortness of breath, and coma. The goals of ventilation are to facilitate carbon dioxide release and maintain normal oxygen levels in the blood. Various modes aim to individualize treatment based on a patient's needs, including controlled, supported, combined, and spontaneous breathing modes.
The document provides information on indications for mechanical ventilation, criteria for instituting ventilation based on pulmonary function and blood gas parameters, settings for mechanical ventilation including tidal volume, respiratory rate, PEEP, and oxygen concentration. It also outlines the basics of various ventilator modes including assist-control, pressure support, and SIMV. Guidelines are provided for initiating mechanical ventilation and troubleshooting issues like high pressures, low volumes, and patient-ventilator dysynchrony. The nurse's key roles in monitoring the patient and equipment are also summarized.
Modern ventilators use electromagnetic valves and microprocessors to control gas flow. They monitor factors like fractional inspired oxygen (FiO2), tidal volume, minute volume, respiratory rate, inspiratory/expiratory ratio, positive end expiratory pressure (PEEP), auto-PEEP, peak airway pressure, plateau pressure, resistance, compliance, recruitment, weaning, and anatomic dead space to ensure accurate ventilation and oxygen delivery to patients. Key settings and measurements include tidal volume of 6-8 ml/kg of ideal body weight, PEEP which improves gas exchange by recruiting alveoli, and plateau pressure which is generally 10-15 cm H2O less than peak pressure.
This document provides an overview of mechanical ventilation basics, including key terminology, oxygenation, ventilation, and basic modes of ventilation. It defines common terms like FiO2, PIP, PEEP, tidal volume, and rate. It explains that oxygenation depends on factors like MAP, FiO2, PIP, PEEP, I:E ratio, and flow rate. Ventilation depends on tidal volume, PIP, PEEP, and rate. The basic modes of ventilation - IMV, SIMV, AC, and PSV - vary based on whether the trigger, cycle, and rate are controlled by the ventilator or patient.
This document discusses ventilation in obstructive airway diseases. It provides indications and contraindications for non-invasive ventilation (NIV) including criteria such as respiratory rate greater than 25 breaths per minute and moderate to severe respiratory acidosis. NIV can be used to support patients with acute exacerbations of COPD or asthma to reverse respiratory failure. Ventilator settings aim to support gas exchange, reduce work of breathing, and prevent complications. Dynamic hyperinflation can cause auto-PEEP which increases workload and impairs hemodynamics. Settings to treat auto-PEEP include increasing expiratory time, reducing tidal volume, and applying external PEEP.
Mechanical ventilation involves using a ventilator to mechanically move air into and out of the lungs to maintain proper oxygen and carbon dioxide levels. It has several purposes including improving gas exchange, relieving respiratory distress, and avoiding complications. There are various modes of ventilation including pressure control, volume control, and time-cycled modes. Parameters like tidal volume, respiratory rate, and PEEP must be set and monitored appropriately for different patients and conditions.
Basic concepts in neonatal ventilation - Safe ventilation of neonatemohamed osama hussein
Lecture by by dr Muhammad Ezzat Abdel-Shafy MB.BCh, M.Sc Pediatrics Neonatology Sp. , Benha Children Hospital, provided during our Doctors neonatology workshop, 20th of January 2017
Mechanical ventilation involves using external equipment to control a patient's breathing. It can be invasive (using an endotracheal or tracheostomy tube) or non-invasive. Ventilators measure pressures, volumes, and gas exchange to carefully regulate a patient's ventilation. Settings like tidal volume, PEEP, and inspiratory time must be tailored to the individual patient's condition and needs. The goal is to provide adequate oxygenation and ventilation while avoiding potential harms like barotrauma or volutrauma.
The document provides information about acute respiratory distress syndrome (ARDS). It begins with a brief history of ARDS and provides the clinical definition. It describes the diagnostic criteria and etiology, including that most cases are caused by sepsis, pneumonia, or trauma. It then discusses the normal lung physiology and pathophysiology of ARDS, which involves three phases: exudative, proliferative, and fibrotic. The management section outlines the principles of therapy to provide adequate gas exchange while avoiding secondary injury, including mechanical ventilation protocols, fluid management, and other strategies. It concludes with a discussion of prognosis and recent advances in ARDS management such as protective ventilation strategies.
The document discusses basic principles of mechanical ventilation including factors that can lead to ventilatory failure, airway resistance, lung compliance, hypoventilation, V/Q mismatch, intrapulmonary shunting, and diffusion defects. It also covers different types of ventilator waveforms including pressure, volume, flow and pressure/volume loops which can be used to assess a patient's respiratory status and response to therapy.
This document discusses various physiological concepts related to respiration and mechanical ventilation. It covers topics such as:
- The equation of motion that describes pressure, flow, volume, and resistance during respiration.
- Components of respiratory system mechanics including compliance, resistance, inertance, and their relationships to pressure and volume changes.
- Physiological properties of the lung including surfactant function, pressure-volume curves, and the effects of lung volume on pulmonary vascular resistance.
- Principles of mechanical ventilation including how ventilator settings impact gas exchange, lung volumes, mean airway pressure, and the risks of ventilator-induced lung injury from barotrauma, volutrauma, and atelectra
This presentation is about Food Delivery Systems and how they are developed using the Software Development Life Cycle (SDLC) and other methods. It explains the steps involved in creating a food delivery app, from planning and designing to testing and launching. The slide also covers different tools and technologies used to make these systems work efficiently.
Applications of artificial Intelligence in Mechanical Engineering.pdfAtif Razi
Historically, mechanical engineering has relied heavily on human expertise and empirical methods to solve complex problems. With the introduction of computer-aided design (CAD) and finite element analysis (FEA), the field took its first steps towards digitization. These tools allowed engineers to simulate and analyze mechanical systems with greater accuracy and efficiency. However, the sheer volume of data generated by modern engineering systems and the increasing complexity of these systems have necessitated more advanced analytical tools, paving the way for AI.
AI offers the capability to process vast amounts of data, identify patterns, and make predictions with a level of speed and accuracy unattainable by traditional methods. This has profound implications for mechanical engineering, enabling more efficient design processes, predictive maintenance strategies, and optimized manufacturing operations. AI-driven tools can learn from historical data, adapt to new information, and continuously improve their performance, making them invaluable in tackling the multifaceted challenges of modern mechanical engineering.
Prediction of Electrical Energy Efficiency Using Information on Consumer's Ac...PriyankaKilaniya
Energy efficiency has been important since the latter part of the last century. The main object of this survey is to determine the energy efficiency knowledge among consumers. Two separate districts in Bangladesh are selected to conduct the survey on households and showrooms about the energy and seller also. The survey uses the data to find some regression equations from which it is easy to predict energy efficiency knowledge. The data is analyzed and calculated based on five important criteria. The initial target was to find some factors that help predict a person's energy efficiency knowledge. From the survey, it is found that the energy efficiency awareness among the people of our country is very low. Relationships between household energy use behaviors are estimated using a unique dataset of about 40 households and 20 showrooms in Bangladesh's Chapainawabganj and Bagerhat districts. Knowledge of energy consumption and energy efficiency technology options is found to be associated with household use of energy conservation practices. Household characteristics also influence household energy use behavior. Younger household cohorts are more likely to adopt energy-efficient technologies and energy conservation practices and place primary importance on energy saving for environmental reasons. Education also influences attitudes toward energy conservation in Bangladesh. Low-education households indicate they primarily save electricity for the environment while high-education households indicate they are motivated by environmental concerns.
We have designed & manufacture the Lubi Valves LBF series type of Butterfly Valves for General Utility Water applications as well as for HVAC applications.
Blood finder application project report (1).pdfKamal Acharya
Blood Finder is an emergency time app where a user can search for the blood banks as
well as the registered blood donors around Mumbai. This application also provide an
opportunity for the user of this application to become a registered donor for this user have
to enroll for the donor request from the application itself. If the admin wish to make user
a registered donor, with some of the formalities with the organization it can be done.
Specialization of this application is that the user will not have to register on sign-in for
searching the blood banks and blood donors it can be just done by installing the
application to the mobile.
The purpose of making this application is to save the user’s time for searching blood of
needed blood group during the time of the emergency.
This is an android application developed in Java and XML with the connectivity of
SQLite database. This application will provide most of basic functionality required for an
emergency time application. All the details of Blood banks and Blood donors are stored
in the database i.e. SQLite.
This application allowed the user to get all the information regarding blood banks and
blood donors such as Name, Number, Address, Blood Group, rather than searching it on
the different websites and wasting the precious time. This application is effective and
user friendly.
Null Bangalore | Pentesters Approach to AWS IAMDivyanshu
#Abstract:
- Learn more about the real-world methods for auditing AWS IAM (Identity and Access Management) as a pentester. So let us proceed with a brief discussion of IAM as well as some typical misconfigurations and their potential exploits in order to reinforce the understanding of IAM security best practices.
- Gain actionable insights into AWS IAM policies and roles, using hands on approach.
#Prerequisites:
- Basic understanding of AWS services and architecture
- Familiarity with cloud security concepts
- Experience using the AWS Management Console or AWS CLI.
- For hands on lab create account on [killercoda.com](https://killercoda.com/cloudsecurity-scenario/)
# Scenario Covered:
- Basics of IAM in AWS
- Implementing IAM Policies with Least Privilege to Manage S3 Bucket
- Objective: Create an S3 bucket with least privilege IAM policy and validate access.
- Steps:
- Create S3 bucket.
- Attach least privilege policy to IAM user.
- Validate access.
- Exploiting IAM PassRole Misconfiguration
-Allows a user to pass a specific IAM role to an AWS service (ec2), typically used for service access delegation. Then exploit PassRole Misconfiguration granting unauthorized access to sensitive resources.
- Objective: Demonstrate how a PassRole misconfiguration can grant unauthorized access.
- Steps:
- Allow user to pass IAM role to EC2.
- Exploit misconfiguration for unauthorized access.
- Access sensitive resources.
- Exploiting IAM AssumeRole Misconfiguration with Overly Permissive Role
- An overly permissive IAM role configuration can lead to privilege escalation by creating a role with administrative privileges and allow a user to assume this role.
- Objective: Show how overly permissive IAM roles can lead to privilege escalation.
- Steps:
- Create role with administrative privileges.
- Allow user to assume the role.
- Perform administrative actions.
- Differentiation between PassRole vs AssumeRole
Try at [killercoda.com](https://killercoda.com/cloudsecurity-scenario/)
Supermarket Management System Project Report.pdfKamal Acharya
Supermarket management is a stand-alone J2EE using Eclipse Juno program.
This project contains all the necessary required information about maintaining
the supermarket billing system.
The core idea of this project to minimize the paper work and centralize the
data. Here all the communication is taken in secure manner. That is, in this
application the information will be stored in client itself. For further security the
data base is stored in the back-end oracle and so no intruders can access it.
Height and depth gauge linear metrology.pdfq30122000
Height gauges may also be used to measure the height of an object by using the underside of the scriber as the datum. The datum may be permanently fixed or the height gauge may have provision to adjust the scale, this is done by sliding the scale vertically along the body of the height gauge by turning a fine feed screw at the top of the gauge; then with the scriber set to the same level as the base, the scale can be matched to it. This adjustment allows different scribers or probes to be used, as well as adjusting for any errors in a damaged or resharpened probe.
A high-Speed Communication System is based on the Design of a Bi-NoC Router, ...DharmaBanothu
The Network on Chip (NoC) has emerged as an effective
solution for intercommunication infrastructure within System on
Chip (SoC) designs, overcoming the limitations of traditional
methods that face significant bottlenecks. However, the complexity
of NoC design presents numerous challenges related to
performance metrics such as scalability, latency, power
consumption, and signal integrity. This project addresses the
issues within the router's memory unit and proposes an enhanced
memory structure. To achieve efficient data transfer, FIFO buffers
are implemented in distributed RAM and virtual channels for
FPGA-based NoC. The project introduces advanced FIFO-based
memory units within the NoC router, assessing their performance
in a Bi-directional NoC (Bi-NoC) configuration. The primary
objective is to reduce the router's workload while enhancing the
FIFO internal structure. To further improve data transfer speed,
a Bi-NoC with a self-configurable intercommunication channel is
suggested. Simulation and synthesis results demonstrate
guaranteed throughput, predictable latency, and equitable
network access, showing significant improvement over previous
designs
Open Channel Flow: fluid flow with a free surfaceIndrajeet sahu
Open Channel Flow: This topic focuses on fluid flow with a free surface, such as in rivers, canals, and drainage ditches. Key concepts include the classification of flow types (steady vs. unsteady, uniform vs. non-uniform), hydraulic radius, flow resistance, Manning's equation, critical flow conditions, and energy and momentum principles. It also covers flow measurement techniques, gradually varied flow analysis, and the design of open channels. Understanding these principles is vital for effective water resource management and engineering applications.
Digital Twins Computer Networking Paper Presentation.pptxaryanpankaj78
A Digital Twin in computer networking is a virtual representation of a physical network, used to simulate, analyze, and optimize network performance and reliability. It leverages real-time data to enhance network management, predict issues, and improve decision-making processes.
2. Hypoxemia :
P(A − a)O2 gradient (mm Hg) 25-65
Palveolar=FIO2(Patm-PH2O)=150
(0.21x(760-47) = 149.7 at sea level 100% humidity
Aa gardient=Palv-4/5PCO2-PaO2=5-10
Increment reflects V/Q mismatch, diffusion problem (ARDS) and right to left shunt
SaO2 below 90% despite supplemental oxygen
Hypoxic index below 300 (pneumonia, ARDS or aspiration)
Hypercarbia
PaCO2 acute increase than basal line
Respiratory acidosis PH below 7.2
Disturbed conscious level due to hypoventilaion
Indications of mechanical ventilation
3. Oxygen delivery/oxygen consumption imbalance
Elevated lactate ≥4 mg/dL despite adequate resuscitation
Decreased mixed venous oxygen saturation <70% despite adequate acute resuscitation
Increased work of breathing
Dead space more than 0.5 acute
Vd/VT=PaCo2-PeCo2/PaCo2
Inspiratory muscle weakness
Negative inspiratory pressure below 20-30 mm Hg
Vital capacity below 15 ml/kg
Acute decompensated heart
Decompensated heart failure
Jugular venous distension
Pulmonary oedema
4. Oxygen delivery/oxygen consumption imbalance
Elevated lactate ≥4 mg/dL despite adequate resuscitation
Decreased mixed venous oxygen saturation <70% despite adequate acute
resuscitation
Increased work of breathing
Dead space more than 0.5 acute
Vd/VT=PaCo2-PeCo2/PaCo2
Inspiratory muscle weakness
Negative inspiratory pressure below 20-30 mm Hg
Vital capacity below 15 ml/kg
Acute decompensated heart
Decompensated heart failure
Pulmonary oedema
Jugular venous distension
5. Inadequate lung expansion
VT below 4 ml/kgm
Vital capacity below 10ml/kgm
Respiratory rate more than 35 per minute
6. Hippocrates likely gave the first description of endotracheal
intubation “One should introduce a cannula into the trachea
along the jawbone so that air can be drawn into the lungs.”
The first known mechanical device designed specifically to
provide ventilation for the patient was the foot pump developed
by Fell and O’Dwyer in the 1880s
History
7.
8. First generations of mechanical ventialators invented and
applied a negative pressure around the body or chest cavity
Two classic devices that provided negative-pressure ventilation
were the iron lung and the chest cuirass widely used during the
poliomyelitis epidemics of the 1930s and 1940s.
After the polio epidemic of the 1960s, the era of respiratory
intensive care emerged, as positive-pressure ventilation via an
artificial airway became common place
11. Negative pressure ventilation decreased a lot in early 80s then continue for a while
in the 90 lung jacket and cruras.
Physiologic they may lead to decrease venous return especially in hypovolemia as
they apply negative pressure in abdomen as well as the chest.
12.
13. Diaphragmatic and intercostal muscle activation during normal inspiration
expands the chest and decreases intrapleural pressure from –5 cm H2O to –8
cm H2O. Alveolar pressure fluctuates from 0 cm H2O during exhalation to –4
cm H2O during inspiration.
Normal venous admixture is about 2% to 5%. Mechanical ventilation may
increase the venous admixture to approximately 10% in the normal individual.
Anatomic dead space is the volume of the conducting airways of the lungs,
about 150 mL. Alveolar dead space refers to alveoli that are overventilated
relative to perfusion; it is increased by any condition that reduces pulmonary
blood flow, such as pulmonary embolism (PE) or with overdistention of the
lung. Mechanical dead space refers to the rebreathed volume of the ventilator
circuit; this volume behaves like an extension of the anatomic dead space.
Mechanical ventilation can also increase dead space if it leads to
overdistention.
Basic concepts
14.
15. Dead space can be calculated by the following equation:
𝑉𝐷/𝑉𝑇=
𝑃𝑎𝐶𝑜2−𝑃𝑒𝑡𝐶𝑜2
𝑃𝑎𝐶𝑜2
this is equals shunt fraction in the lung
Causes of increase is
pulmonary embolism
lung contusion
lung consolidation
An increased dead space fraction requires a greater minute ventilation to maintain alveolar ventilation and Paco2
Hypoventilation raises Paco2: a modest elevation (50-70 mm Hg) reduces pH and is usually not by itself injurious in the
mechanically ventilated patient.
19. Compliance: change in volume per unit change in pressure. ( inside alveolus)
(CRS) is ΔV/ΔPalveolar
equation of motion: Muscle pressure + Ventilator pressure = (Elastance x
Volume)+(resistance x flow)
Elastance is the inverse of compliance.
Resistance describes the impedance to airflow through the respiratory
system.
elastic load is the pressure required to overcome the elastance of the
respiratory system.
resistive load is the pressure required to overcome flow resistance of the
ventilator circuit, endotracheal tube, and airways.
20. Muscle power: Elastance X Volume= 1/compliance X Volume = ΔP/ΔV X Volume = ΔP
Both volumes are tidal volume so muscle power is ∆P
during mandatory ventilation no muscle contraction and no pressure change due to muscle contraction
N.B bipap where spontaneous breathing is allowed during mandatory breath
22. Ppeak Maximum pressure in the proximal
airway at the end of inspiration it is the
pressure responsible for deliver tidal
volume
Pplateau Equilibrium pressure reached if
the expiratory tube is occluded at the
end of inspiration (no flowin the circuit)
PEEP: Positive end expiratory pressure its
pressure left in the alveoli to prevent its
collapse
PEEPi auto PEEP its due to trapped air
volume in the lung to get rid of it
prolong expiration or disconnect circuit
then reconnect as it causes hypoxia and
hypoventilation
Airway Pressures
23. Airway pressures
time
pressure
Pres
Pplat
Pres
Scenario # 1
Paw(peak) = (Flow x Resistance) + (Volume x 1/ Compliance)
Paw(peak)
This is a normal
pressure- time waveform
with normal peak
pressures ( Ppeak) ;
plateau pressures (Pplat )
and airway resistance
pressures (Pres)
24. It represents the area under the curve
Increase mean airway pressure improve
oxygenation
Items increase mean airway pressure
Increase PEEP
decrease insp. Time
Increase tidal volume
Flow increase
Spasm (airway obst.)
Mean airway pressure
25. Resistance: is the impedance of airway and tubing system to flow it increases on mechanical ventilation
Airway resistance= (PIP-PPlat)/Flow cmH2o.L/sec
Non intubated its only0.6-2.4 in intubated its 4-6
26. Boyle marriot law P X V = constant
Resistance is measured as pressure difference between beginning and end
the tube and the flow of gas volume per unit time.
R= ∆P/flow(mbar/L/second)
Healthy 2-4 higher in children and infant
Intubated 4-6
𝐦𝐚𝐱𝐢𝐦𝐮𝐦 𝐩𝐫𝐞𝐬𝐬𝐮𝐫𝐞 − 𝐩𝐥𝐚𝐭𝐞𝐚𝐮 𝐩𝐫𝐞𝐬𝐬𝐮𝐫𝐞
𝐟𝐥𝐨𝐰
Hangen posseuille’s law:
𝐑 ∝ 𝟏
𝐫𝟒
r is the radius of the airway
27. It is a compressible tubes designed to deliver air from ventilator to ETT or TT
or mask.
It is responsible for discrepancy between VT inspired and VTe.
Its compliance is equal 2-3 cm3/cm H2o
Part of it is the humidifier which is responsible for humidification and
adjusting temperature of inspired air to reach alveoli near 37oc. And fully
humidified 44 mg/L.
It is well known that lung uses daily 250 ml water to humidify air delivered
Ventilator circuit
28. An HME, which is placed between the artificial airway
and the ventilator circuit, may be used to replace the
traditional heated humidifier. During exhalation,
moisture and heat from the patient are absorbed into
the honeycomb structure of the exchanger and are
transferred back to the patient during the next
inhalation. Ventilator circuits with bacterial-viral
filtering HMEs cost less to maintain and are less likely
to colonize bacteria than those with heated
humidifiers..
HME(heat moisture exchange)
29. Contraindications for use of an HME:
Thick or large amounts of secretions
minute volume exceeding 10 L/minute
body temperature less than 32° C
need for aerosolized medications
30.
31. Time constant
time constant always equals the length of time needed for the lungs to inflate or deflate to a certain
amount (percentage) of their volume.
One time constant allows 63% of the volume to be exhaled (or inhaled), two time constants allow about
86% of the volume to be exhaled (or inhaled), three time constants allow about 95% to be exhaled (or
inhaled), and four time constants allow 98% of the volume to be exhaled (or inhaled)
Time constant = C × R
We need to set expiratory time constant to 3 or 4 to ensure exhalation of most of air and prevent
autopeep
33. represents the change from expiration to inspiration and
occurs either because of a drop in circuit pressure or diversion
of flow (when patient triggered)
Sensitivity refers to a preset threshold of pressure or flow
rarely volume. When this threshold is reached, a mechanical
breath is delivered.
Pressure trigger If sensitivity is set too low, the ventilator will
be triggered by any process that causes the airway pressure
to drop below the set threshold autotrigger.
Triggering
34. if the threshold is set too high, the work of breathing increases, as
the patient must make a significant effort to overcome the
threshold increase respiratory work.
In the setting of flow triggering, the patient’s inspiratory effort
induces a disruption of the constant flow in the ventilator
inspiratory circuit. This change in flow signals the expiratory valve
to close and for the ventilator to deliver the next breath.
35. Ventilator trigger (mandatory ventilation) is by time trigger the ventilator controls the number of breaths
delivered per minute.(CMV or controlled mandatory ventilation)
Patient trigger by (assisted ventilation)
Flow if flow is 5 L/min this means patient initiate spontaneous breathing normal flow of return of gas its 2
L/sec
Volume trigger occurs when the ventilator detects a small drop in volume in the patient circuit during
exhalation. The machine interprets this drop in volume as a patient effort and begins inspiration.
Pressure usually is set at about −3 cm H2O. The operator must set the sensitivity level to fit the patient’s
needs. If it is set incorrectly, the ventilator may not be sensitive enough to the patient’s effort, and the
patient will have to work too hard to trigger the breath
36. Wave forms
Square or rectangle: rapid rise to maximum
pressure then tidal delivered fast giving way to
expiration which is longer as short inspiratory best
used with COPD leaving longer exp.
Decelerating or exponential: it is pressure target
as the pressure increase in alveoli flow
decrease(flow curve decelerate) longer Tinsp good
for hypoxic condition as ARDS
Sinusoidal: it is the normal breathing of normal
lung it may be good with cause of ventilation is
outside lung as in neuromuscular disease and
guillian barre.
37. Insp.
hold
A plateau pressure measurement can be obtained in assist volume control
mode by the performance of an inspiratory hold to better estimate the
pressure in the lungs.
38.
39.
40. This phase can be controlled by how one sets flow or pressure in the
ventilator proximal to the open inspiratory valve. For example, volume-assist
control is flow controlled and pressure-assist control is pressure controlled.
Choice of type of control is clinician decision as both can achieve goals.
It should be noted, though, that in volume-targeted ventilation, excessive
airway pressures can arise secondary to worsening pulmonary mechanics. In
this situation, the pressure alarm will cause a pressure limit to cycle to
expiration. (overdistension …. Dead space)
Inspiration
41. In pressure control volume is not guaranteed it
depends on lung compliance and resistance monitoring
depends on PH and Paco2.
In pressure control flow is naturally decelerating as
pressure in the airway increases flow decreases flow it is
naturally decelerating but it can be altered by
ventilator. Autoflow
42. During inspiration we set ventilator on either pressure control (PCV) or volume control(VCV) with their
subtypes but we may use the alarm as a limit developing mixed type of ventilation for example volume
control pressure limit
A limit variable is the maximum value a variable (pressure, volume, flow, or time) can attain. This limits
the variable during inspiration, but it does not end the inspiratory phase.
As an example, a ventilator is set to deliver a maximum pressure of 25 cm H2O and the inspiratory time
is set at 2 seconds. The maximum pressure that can be attained during inspiration is 25 cm H2O, but
inspiration will end only after 2 seconds has passed.
43. • Male patient 60 years old developed ARDS with compliance of 10 ml/cmH2o patient body weight is
100 Kgms clinician decided to set parameter as follows
VCV with VT=5 ml/Kgm
F 20
Tinsp=1 sec
flow wave is square
PEEP 10
FiO2 100%
RAMP 0 second
ALARMS set Pressure limit 40 High RR 20 calculate actual minute volume provided patient had no spontaneous breathing
44. VT given is equal 5X100=500
Actual is pressure limit (PIP)-PEEP=40-10=30
Then VT=PXC=30X10= 300
MV=300X20=6000
Provided flow 60 and plateau 30 and compliance became 20 does this patient had bronchospasm or not
45. Resistance= PIP-Pplat/flow (l/sec)=5
Then patient had no bronhspasm
Does this patient had autoPEEP
Time constant= CXR=0.02X5=0.1sec then expiration is 3-4X0.1sec=0.4 seconds
46. Cycling is the transition from inspiration to expiration
(closing inspiratory valve and opening expiratory valve).
Flow cycled: in PS breaths it is to set ceasation of inspiration at certain
limit of decrease of flow typically it is set at 25%of initial flow we may
increase it in certain condition as bronchopleural fistula.
Time cycled: inspiration is terminated after a preset interval, regardless of
whether preset pressure has been achieved or a desired tidal volume has
been delivered. yielding a square pressure waveform. Delivered VT
depends on Tinsp as VT=Flow X Tinsp
Flow: 60 L/sec Tinsp 1sec VT=1L.
cycling
47. Volume cycled: in volume control ventilation Volume is delivered until that volume is reached
and may stop early if a preset pressure limit or exceeds pressure alarm limit of ventilation. if
there is inspiratory pause ventilation will continue till end on inspiratory pause and still its
volume cycled not time cycled
Flow: 60 L/sec
VT: 500
Inspiratory pause 0.5 second
Therefore Tinsp will be 1second
48. All ventilators have a maximum pressure limit control, which is used to prevent excessive pressure from
reaching a patient’s lungs. This maximum safety pressure is typically set by the operator to a value of 10
cm H2O above the average peak inspiratory pressure.
Reaching the maximum high-pressure limit ends the inspiratory phase. The machine is therefore
pressure cycled for that breath.
Ventilators also have an internal maximum safety pressure. By design, the machine cannot exceed that
limit, regardless of the value set by the operator. Ventilator manufacturers usually set internal maximum
safety pressure at 120 cm H2o
49. The expiratory phase encompasses the period between inspirations.
During mechanical ventilation, expiration begins when inspiration
ends, the expiratory valve opens, and expiratory flow begins. As
already mentioned, opening of the expiratory valve may be delayed if
an inspiration hold (pause) is used to prolong inspiration.
The pressure level from which a ventilator breath begins is called the
baseline pressure (PEEP or zero if PEEP is zero)
Expiration
50. Control Variables Control variables are the main variables the ventilator adjusts to produce inspiration.
The two primary control variables are pressure and volume.
Phase Variables Phase variables control the four phases of a breath (i.e., beginning inspiration,
inspiration, end inspiration, and expiration). Types of phase variables include :
Trigger variable (begins inspiration)
Limit variable (restricts the magnitude of a variable during inspiration)
Cycle variable (ends inspiration)
Baseline variable (the parameter controlled during exhalation)
51. Types of Breaths :
Mandatory breaths: The ventilator determines the start time for breaths (time triggered)
or the tidal volume (volume cycled).
Spontaneous breaths: Breaths are started by the patient (patient triggered), and tidal
volume delivery is determined by the patient (patient cycled)
Assist ventilation: Patient trigger ventilation either (Volume, Pressure or flow) and
ventilator support the ventilation.
52. Volume control ventilation
Advantage of volume control modes to be sure of preset tidal volume delivery with target
PaCo2.
Disadvantage is if lung mechanics change (compliance or sort of airway obstruction) tidal
volume will delivered with higher peak pressure and plateau pressure overdistension of
alveoli worsen lung condition and may cause barotrauma and pneumothorax.
53. Factors That Affect Pressures During Volume-
Controlled Ventilation
• Patient Lung Characteristics
Reductions in lung or chest wall compliance produce higher peak and plateau pressures;
increased compliance produces lower peak and plateau pressures.
Increased airway resistance produces a higher peak pressure; reductions in airways resistance
produce lower peak pressures.
• Inspiratory Flow Pattern
Peak pressure is higher with a constant flow and lower with a decelerating flow pattern.
Decelerating flow pattern has a higher mean airway pressure; constant flow generates the
lowest mean airway pressure
High inspiratory gas flow creates a higher peak pressure.
54. • Volume Setting
High volumes produce higher peak and plateau pressures; low volumes produce lower peak
and plateau pressures.
• Positive End-Expiratory Pressure (PEEP)
Increasing PEEP increases the peak and mean pressures. Auto-PEEP
Increases in auto-PEEP increase the peak inspiratory pressure.
55. Other disadvantages of volume-controlled breaths are related to flow and sensitivity
settings. Specifically, the delivery of flow is fixed on some ventilators and may not
match patient demand. Similarly, if the sensitivity level is not set appropriately for the
patient, it can make it more difficult for the patient to trigger inspiration. Both
situations can lead to patient-ventilator asynchrony and patient discomfort.
56. Pressure control ventilation
When choosing pressure as the variable
Advantages of pressure control is :
It limits pressure as the peak pressure is limited to preset pressure preventing overdistension
It uses decelerating flow making peak pressure more close to normal
Disadvantages
Volume delivery varies
Change in lung mechanics may lead to decrease in minute ventilation to compromise ventilation
57. Factors That Affect Volume Delivery During
Pressure-Controlled Ventilation
Pressure Setting Higher pressure settings produce larger volumes, whereas lower pressure settings
produce lower volumes. In other words, increasing the peak inspiratory pressure (PIP) while maintaining
a constant end-expiratory pressure (EEP) increases volume delivery (and vice versa).
Pressure Gradient • Increasing EEP (PEEP+ auto-PEEP) while keeping PIP constant reduces the pressure
gradient (PIP − EEP) and lowers volume delivery (and vice versa).
58. Patient Lung Characteristics
Reduced compliance results in lower volume; increased compliance results in increased volume for a given
inspiratory pressure.
Increased airway resistance (Raw) results in lower volume delivery if active flow is present; reductions in airway
resistance results in higher volume delivery if active flow is present.
With an increased Raw, after flow drops to zero during inspiration, resistance no longer affects tidal volume (VT)
(i.e., no flow, no resistance).
59. Inspiratory Time : When the inspiratory time (TI) is extended, volume delivery increases. This
is true as long as flow is present during inspiration (i.e., the flow-time curve shows flow
above zero when inspiration ends). However, if flow returns to zero before inspiration ends,
further increases in TI can decrease volume delivery if adequate time is not provided for
exhalation.
Patient Effort: Active inspiration by the patient can increase volume delivery.
60. Any type of ventilation for every patient but its better to choose pressure type in
lung protective strategy as ARDS and volume to control PaCo2
61. It is the first positive pressure ventilation mode
Locking out a patient by making the ventilator totally insensitive to patient effort
Patient must be sedated and on neuromuscular blockade
Data set:
Tidal volume
Time cycled or volume cycled
Respiratory rate
Control flow or pressure
Controlled mechanical ventilation
continuous mandatory ventilation
CMV
62.
63.
64. Advantages:
Rests muscles of respiration
Disadvantages:
Requires use of heavy sedation/neuromuscular
blockade
65. 2 types volume and pressure
Volume type it differs from CMV that ventilator feels
the patient needs if patient try to trigger ventilator
assist patient and let him had a full breath another
thing we set peak flow if ventilator feels peak
pressure increased it increase peak flow.
Assist control mandatory ventilation
A/C
66. Trigger : patient or time
Cycling: time
Wave form: Square, decelerating
Control: flow
67. To start a patient on assist-control one must select a PEEP (as
determined by lung compliance), a minute volume (MV
100ml/kg), a tidal volume (TV 6ml/kg), and a peak flow. The
respiratory rate is the MV/TV. The peak flow is usually four times
the minute ventilation. The trigger is either set as “flow-by” or a
negative pressure of -2cmH2O. Refinement of the settings is
determined by the patient’s plateau pressure (should be less than
30cmH2O), the patients inspiratory flow demand, and blood gas
targets.
68.
69. Trigger: patient or time
Control: Pressure
Cycling: time
Wave: decelerating
Pressure control/assist control (PC/AC)
70.
71. Advantages:
Reduced work of breathing
Guarantees delivery of set tidal volume (unless peak pressure
limit alarm is exceeded)
Disadvantages:
Potential adverse hemodynamic effects
May lead to inappropriate hyperventilation and excessive
inspiration pressures
72. Volume control assist control lead to increase patient effort by 33-50% of flow is inadequate known by
concave pressure wave form
PC CMV is used in early 90s to ventilate ARDS before developing of SIMV and BIPAP patient was put on
this mode and limit pressure above pressure control by 10 cmH2o.
Pressure control also develop from it PCIRV which is pressure control inversed ratio ventilation to
prolong inspiration more than expiration to ventilate very stiff lung.(in expense of autoPEEP and high
peak airway pressure)