ventilator graphics that shows scalar and loops
- 1. Ventilator Graphics FAY A L B U A I N A I N
- 2. Objectives: • Introduction • Why We Need To Know About The Ventilator Graphics ? • Types Of Waveforms • Types Of Breath • Normal And Abnormal Waveforms
- 3. Introduction: Monitoring and analysis of graphic display of curves and loops during mechanical ventilation has become critical to determine how patient is being ventilated to assess problems occurring during ventilation.
- 4. Mode function Auto PEEP Synchrony Trigger WOB Over distension PEEP Ti Leak Flow cycle Time rise Active exhalation Why we need to know about the ventilator graphics ?
- 6. Scalars
- 7. Types Of Waveforms: VC-CMV SIMV+VC PC-CMV VAP APRV SIMV+PC PSV • Constant • Sinusoidal • Ascending • Descending • Exponential • Ascending • Sinusoidal • Constant • Exponential • Constant • Sinusoidal • Ascending • Descending • Exponential • Ascending • Sinusoidal • Constant • Exponential VC PC ?
- 8. Type Of Breath: Mandatory Assisted Spontaneous Inspiration Expiration
- 9. P-T PIP Transairway Pressure (PTA) Pplateau PEEP Begin Inspiration Begin Expiration B C A= airway Raw B= Alveolar distending pressure ABC = MAP
- 10. Respiratory Mechanics: ↑ RAW ↓ COMPLIANCE A B A B
- 11. Time rise: Minimal Pressure Overshoot P What is the benefit of the time rise ?
- 12. Inspiration Expiration Time (sec) TI TE F-T Beginning of inspiration exhalation valve closes Peak inspiratory flow rate PIFR End inspiration and beginning of expiration exhalation valve opens Peak expiratory flow rate PEFR
- 14. Abnormalities
- 15. VC 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Increase Raw
- 19. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Inadequate Flow “ Flow Starvation”
- 20. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Active Exhalation
- 21. Loops
- 22. P-V LOOP PIP VT What does that point indicates ?
- 23. Type Of Breath: Controlled Assisted Spontaneous I E E E I I PEEP
- 24. Types Of Waveform: PC Ps VC
- 25. WOB The more vertical the loop lays, the higher the lung compliance, the more horizontal it lays, the lower the lung compliance. Thus slope of the line equals compliance. The fatter the loop, the higher the airway resistance…you can tell if it’s I or E resistance by looking at whether the right or left side bulges out more
- 28. Abnormalities
- 30. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Increase compliance
- 33. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Over Distension
- 37. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Inadequate Flow “ Flow Starvation”
- 38. 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 Active Exhalation
- 41. Assessment of pressure, flow and volume waveforms is a critical tool in the management of the mechanically ventilated patient.
- 42. References: • Pilbeam’s Mechanical Ventilation, 5th edition. • Curves and Loops in Mechanical Ventilation, dragger booklet. • Handbook of Mechanical Ventilation, Kumar B Umesh, 2011. • Maquet pocket guide, • Ventilator Graphics and Respiratory Mechanics in the Patient With Obstructive Lung Disease, 2005.