Mechanical Ventilation Flashcards
Modes
Volume Preset Assist Control
Set: TV, IE cycle, RR, Inspiratory time, Inspiratory pause time, PEEP
Trigger:
- ventilator initiated (control breaths)
- patient initiated (assist breaths)
Delivery: same breath characteristic
- not affected by whether breath is control or assist
End: once reaches target tidal volume
Inspiratory Time
Advantages and Disadvantages of VC
Pressure Preset Assist Control
Pressure measured at the mouth, not alveoli
Set:
Trigger: same as VC
Delivery: same as VC
End:
Not suitable for high compliance, limited volume flow
Advantages and Disadvantages of PC
Pressuee Limited Assist Control with Volume Guarantee (PRVC)
Pressure Support
Trigger: patient initiated, patient can determine how long he breathes
Character: same pressure
End: inspiratory flow cycle (% of max inspiratort flow)
Requires PS 4 to 15
If requires < 6 probably does not require ventilation
Advantages and Disadvantages of PS
SIMV
receives minimum number of mandatory breaths
Set:
Volume controlled
Pressure controlled
FiO2
SImv Rate
Simv period
TV or inspiratory pressure
IE ratio
PS
Peep
Which mode?
Settings
TV = 6-8mL/kg
Based on ideal body weight
RR = 12-16
PEEP minimum 5
Normal ppl PEEP 1-2
ETT bypasses normal PEEP = 0
FiO2
Trigger sensitivity
- flow trigger more sensitive than pressure trigger
When patient tries to breath, negative pressure over ETT or air flow into patient causing loss of flow, both sensed by machine triggering ventilation
Time trigger
MSS-CV
Chest movement
Breath sound
Saturation
Cardiovascular status
Troubleshooting
Urgent problem - MSS CV
Patient problem
Machine problem
Dysynchrony
Algorithm
