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    Ventilator Graphics

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    Ventilator Graphics

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    Ventilator graphics

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    Ventilator graphics

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views57 pages

    Ventilator Graphics

    Uploaded by

    David T
    Ventilator graphics

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 57

    Ventilator Graphics

    Chapter 10
    Graphics
    •  Monitor the function of the ventilator
    •  Evaluate the patient’s response to the ventilator
    •  Help the clinician adjust the ventilator settings
    •  Both scalar and loops
    –  Scalar: pressure volume and flow graphed against
    time
    –  Loops: two variable plotted on the X and Y axis,
    pressure vs volume and flow vs volume
    Clinical Rounds 10-1, p. 182
    A patient is volume 1. Pta=PIP-Pplat:
    ventilated at the following 24-17=7cmH2O
    settings: PIP 24cmH2O; 2. Cstat=Vt/Pplat-PEEP:
    Pplat 17cmH2O; Vt 400/17-5= 33.3ml/cmH2O
    400ml; PEEP 5 cmH2O 3. Raw=Pta/flow: 7/
    1. What is the Pta? (35/60)=12cmH2O/L/s
    2. What is the Cstat? 4. The patient has
    3. Flow is about 35L/min, increased Raw
    what is the Raw?
    4. Is this Raw normal?
    Key Points for Volume Ventilation
    Graphics
    •  Observing PIP, Pplat, Pta, PEEP on the pressure-time scalar
    •  On flow-time scalars locating the beginning of inspiration, the set
    flow, the beginning of exhalation, PEFR, end-expiratory flow, and
    the end of exhalation
    •  Calculating compliance from pressure and flow curves
    •  Observing inspiratory flow of zero during inspiratory pause
    •  Checking for Raw using Pta and the expiratory flow curve
    •  Inadequate sensitivity and inadequate flow and resulting changes in
    the pressure-time curve
    •  Checking for auto-PEEP using the expiratory flow curve
    •  Measuring and observing auto-PEEP levels on the pressure-time
    curve
    •  Checking for leaks and for active exhaltion or transducer error in
    volume-time curves
    •  Different flow patterns during volume ventilation
    Pressure Ventilation
    •  The pressure waveform is rectangular – constant
    •  The pressure waveform is not affected by
    changes in lung characteristics or patient flow
    demand
    •  The rate of flow delivery varies according to the
    lung characteristics, set pressure and inspiratory
    effort
    •  The flow waveform rises rapidly at the beginning
    of inspiration and decreases during inspiration
    (continuously variable decelerating pattern)
    Clinical Rounds 10-2 p. 191
    A patient with ARDS is on PCV Initially it was considered to
    with the following settings increase IP to improve
    PEEP=10; FiO2=.8; IP=18; ventilation and the FiO2 to
    PIP=28; Vt=350 (down from improve oxygenation; but
    450ml) slope set at the slowest better ventilation is actually
    possible flow delivery. ABG’s accomplished by adjusting the
    on these settings are slope to achieve a faster
    7.28/49/53 (↓O2 ↑CO2 from pressure delivery and increase
    previous). The RT notices that the Vt, the PIP will return to 28
    PIP reaches only 23cmH2O. cmH2O and the patient's ABG
    No leaks are found in the values will improve without
    system. What further adjustments
    recommendations might be Evidence in the waveform with
    made to improve this patient’s a tapered inspiratory pressure
    ABG’s? waveform
    Figure 4-5 Identification and correction of overdistention as seen in P-V loops
    Rapid Interpretation of Ventilator Waveforms by Waugh, Deshpande, Harwood
    Figure 11-42 Alveolar pressure plotted (manually) at various volumes to
    Determine the point of alveolar overdistention (upper inflection point)
    Clinical Application of Mechanical Ventilation by Chang © Delamar 2001
    Clinical Applications of Mechanical Ventilation by Chang
    © Delamar 2001

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