Ventilator modes
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There are three main categories of ventilator modes: control, assisted, and spontaneous. Control modes like volume control ventilation (VCV) are used for paralyzed or comatose patients where the ventilator controls breathing. Assisted modes like assisted volume control mandatory ventilation (AVCMV) help patients breathe by providing a minimum tidal volume. Spontaneous modes like positive airway pressure (CPAP/BIPAP) allow breathing without machine triggers and are used non-invasively. Each mode has parameters that can be adjusted based on patient needs like tidal volume, respiratory rate, pressures, and more to provide appropriate ventilation support.
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Background
Mechanical Ventilation is indicated to assist the patient who cannot maintain adequate oxygenation, alveolar ventilation or lacks the ability to protect his or her own airway.The inability of a patient to maintain either the normal delivery of oxygen to the tissues or the normal removal of carbon dioxide from the tissues is referred to as acute respiratory failure. Though the three common indications for mechanical ventilation includes inability to maintain adequate oxygenation, inability to maintain adequate alveolar ventilation and/or inability to protect one’s own airway. There are more specific indications for mechanical ventilation and can be found in the table below.
Indications
Definition
Example
Apnea
Absence of breathing
Cardiac Arrest
Acute
Respiratory Failure (ARF)
Inability of a patient to maintain adequate: PaO2, PaCO2, and, potentially, pH.
Hypoxemic RF
Hypercapnic RF
Impending
Respiratory Failure
Respiratory failure is immi-nent in spite of therapies.
Commonly defined as:
Pt is barely maintaining (or
gradually deteriorating) normal blood gases but
with significant WOB.
Neuromuscular
Disease (N-M)
Status Asthmaticus
Chronic
Respiratory Failure
Repeated failures after attempts to liberate from the ventilator (extubations, Trach Collar trials, etc.)
SEVERE:
Obesity Hypoventilation Syndrome
COPD
Pulmonary Fibrosis
Prophylactic
Ventilatory Support
Clinical indication = high risk of respiratory failure.
Ventilatory support is instituted to ↓ WOB,minimize O2consumption and hypoxemia, reduce cardiopulmonary stress, and/or control airway with sedation.
Brain injury
Heart muscle
Injury
Major surgery
Shock (prolonged)
Smoke injury
Trauma (some)
Hyperventilation Therapy
Ventilatory support is instituted to control and manipulate PaCO2 tor lower than normal level
Acute head injury
(↑ ICP)
(not immediately
after injury)
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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.
Invasive and Non Invasive ventilation .pptx
This document discusses invasive and non-invasive mechanical ventilation. It begins by defining key terms like ventilation, ventilator, and the different types of mechanical ventilation. It then covers the indications for mechanical ventilation including acute respiratory failure, prophylactic support, and hyperventilation therapy. The document discusses various ventilator modes like controlled mandatory ventilation, assist-control, intermittent mandatory ventilation, and more. It also covers settings, problems that can arise, and non-invasive ventilation options like CPAP, BiPAP, and pressure support ventilation.
Mechanical ventilation
A primer on mechanical ventilation modes and uses. Targeted towards residents and nurse practitioners
Care of patient on mechanical ventilator.pptx
Mechanical ventilation provides oxygenation and ventilation for patients who are unable to breathe adequately on their own. It works by delivering positive pressure breaths through an endotracheal tube or tracheostomy. Nurses caring for patients on ventilators must carefully manage the patient's airway, monitor ventilator settings and alarms, prevent complications, and meet the patient's physiological needs. Modes of ventilation include volume control, pressure control, and non-invasive ventilation delivered via face mask. Complications can arise from excessive secretions, equipment issues, or if the patient's breathing is not synchronized with the ventilator.
Care of child requiring long term ventilation
Care of child requiring long term ventilationProf.Dr.Shali.B.S.Mamata College of Nursing,Khammam,Telangana.
This document discusses mechanical ventilation and care of children requiring long-term ventilation. It covers the physiology of ventilation, indications for mechanical ventilation, types of ventilators including transport, ICU, neonatal and PAP ventilators. It describes various ventilation modes like PC, VC, PRVC, SIMV and their applications. Factors in weaning from ventilation are discussed along with complications and troubleshooting. Non-invasive ventilation options like CPAP, BiPAP and protocols for safe weaning are also summarized.Mechanical ventilation
Mechanical ventilation aims to maintain normal blood gases by controlling minute ventilation, oxygen delivery, and ventilation-perfusion matching. The key blood gas measures are pH, pCO2, and pO2. Minute ventilation and pCO2 are closely related and controlled by respiratory rate and tidal volume. pO2 is governed by oxygen delivery via FiO2 and mean airway pressure, which impacts airway recruitment. Modes like volume control directly set tidal volume, while pressure control sets peak pressure indirectly controlling tidal volume. Proper settings must balance the goals of oxygenation and ventilation while avoiding barotrauma.
Anaecon India - Spirometery
Spirometry is a test used to assess lung function by measuring airflow. It can help diagnose obstructive lung diseases like COPD and asthma by measuring airflow limitation through values like FEV1 and FEV1/FVC ratio. A spirometry report provides values for volumes of air inhaled and exhaled that are compared to predicted normal values to identify restrictive or obstructive lung abnormalities. Quality control measures ensure accurate spirometry administration and interpretation.
2.Ventilator Settings by Dr.Ateia.pptx
This document discusses ventilator settings for mechanical ventilation. It begins by outlining the components of ventilators including controls, monitors, alarms, and accessories. It then discusses initial ventilator settings such as setting the mode to assist control, fractional inspired oxygen to 100%, positive end-expiratory pressure starting at 5 cm H2O, respiratory rate of 12-20 breaths per minute, tidal volume of 5-12 cc/kg based on patient characteristics, inspiratory to expiratory ratio of 1:2 or 1:1.5, and sensitivity/trigger settings. Safety considerations are also outlined such as having a manual resuscitation bag available and double checking settings against pressure and volume measurements.
Care of patient on ventilator
1. The document provides guidelines for the care of patients requiring mechanical ventilation including indications for ventilation, modes of ventilation, troubleshooting alarms, weaning criteria and processes, and complications.
2. Mechanical ventilation is used to support breathing for those unable to maintain adequate oxygen or CO2 levels spontaneously, including those with respiratory failure, neuromuscular diseases, or trauma/illnesses affecting breathing.
3. Modes of ventilation include controlled, assisted, intermittent mandatory, and pressure support modes. Nurses must monitor for alarms related to pressures, volumes, and apnea and address causes such as tubing issues or secretions.
CARE OF CHILD REQUIRING LONG TERM VENTILATOR.pptx
This document discusses care of children requiring long-term ventilation. It covers incidence rates, goals and modes of mechanical ventilation, guidelines for monitoring ventilated children, and weaning from ventilation. Complications of long-term ventilation are also discussed. Bundles of care are mentioned as a way to standardize best practices and improve patient outcomes for ventilated children.
Care and basic settings of portable ventilator.pdf
This document discusses mechanical ventilation and ventilator settings. It defines mechanical ventilation as using a mechanical device to assist breathing. The main types are negative pressure ventilation, which applies pressure lower than atmospheric pressure during inspiration, and positive pressure ventilation, which applies higher pressure during inspiration. Modes of ventilation discussed include volume control, pressure control, SIMV, PSV, and CPAP. Key ventilator settings covered are tidal volume, respiratory rate, FiO2, PEEP, I:E ratio, and pressure support. Causes of respiratory failure and appropriate ventilator care are also summarized.
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Ventilator modes
- 1. VentilatorModes Modes Control Assisted Spontaneous 1: VCV 1: AVCMV 1: PSV 2: PCV 2: APCMV a) CPAP 3: SIMV b) BIPAP a) SIMV+PS b) SIMV+VS Control mode: Volume control ventilation (VCV): VCV mode is the mode of choice for paralysed and comatose patient. Respiratory therapist usually put the patient first on VCV mode. In VCV mode, the volume is constant but the pressure is variable. Putting patient on VCV mode require complete sedation or paralysis. In VCV mode, the ICU nurse usually observes the peak pressure (the pressure of air in dead spaces of the lungs after a forceful expiration) and Plato pressure (pressure air in alveoli after forceful expiration). If the peak pressure raises above the 45 cmH2O then he or she first find the cause of this pressure i.e. mucus plug, narrowness of bronchi due to secretion etc. Then he or she sucks the secretion by suctioning machine and leave the patient on VCV mode. If the there is no special cause for raising the pressure then the nurse put the patient on PCV mode. If the Plato pressure rises above 30 cmH2O, the nurse immediately put patient on PCV mode to prevent alveolar destruction. Indication for VCV mode: ABGs disturbance. Paralysis of respiratory muscals. Parameters for VCV mode: VT (tidal volume) 6 – 8 ml/kg. Patient totally dependent on ventilator. Ventilator helps the patient in breathing. Respiratory therapist usually uses this mode for trails.
- 2. RR (respiratoryrate)12- 20 breath/min. FiO2 (fraction ofinspiredoxygen):100%. PEEP (positiveendexpiratorypressure):0- 5 cmH2O. I: E (ratio ofinspiration & expiration):1 ratio 2. Pressure control ventilation: In PCV mode, the pressure is constant but the volume is variable. Parameters for PCV mode: RR (respiratoryrate)12- 20 breath/min. FiO2 (fraction ofinspiredoxygen):100%. PEEP (positiveendexpiratorypressure):0- 5 cmH2O. I: E (ratio ofinspiration & expiration):1 ratio 2. IP (inspiredpressure):5 to 30 cm H2O, maximum 14 cm H2O pressure, we can give to patient during ventilation. Another unit for this pressure is mmHg. Assistedventilatory mode: Assistedvolume control mandatory ventilation (AVCMV): VT, RR, FiO2, PEEP, I: E. In AVCMV mode we fix the tidal volume as well as respiratory rate. For example we fix VT 500 ml and RR 15 breath/m, while the patient taking 20 breath per mint with VT 300, then the ventilator assist the patient and give him 500 ml air in each breath. Assistedpressure control mandatory ventilation (APCMV): IP, RR, FiO2, PEEP, I: E. Synchronize intermittent mandatory ventilation (SIMV): VT, RR, FiO2, PEEP, Drawback? 1. SIMV+ pressure support: 2. SIMV+ volume support: Spontaneous Mode: Use for non-invasive as well as invasive ventilation. Positive spontaneous ventilation: PS= 5 to 15 FiO2= 30% CPAP: Continue positive airway pressure: (uni-level pressure) IPAP: 5 to 30 cm H2O EPAP FiO2
- 3. Indication: type 1 respiratory failure (decrease oxygen saturation), CHF, pulmonary edema. BIPAP: bi-level positive airway pressure: IPAP: 5 to 30 cm H2O EPAP: 4 to 14 cm H2O Indication: CO2 poising, chronic asthma, ABGs disturbance, Type 2 respiratory failure (decrease oxygen saturation as well as increase carbon dioxides.