basic of mv rsu 54
DESCRIPTION
Basic of MV RSU 54TRANSCRIPT
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Basic of Mechanical Basic of Mechanical VentilatorVentilator
Dr. Kriangsak AtipornwanichRajavithi Hospital
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Mechanical Ventilators (MV)Mechanical Ventilators (MV)
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IndicationIndication forfor mechanicalmechanical ventilationventilation
Hypoxic respiratory failure Hypercapnic respiratory failure
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Hypoxic respiratory failureHypoxic respiratory failure
PaO2 < 60 mmHg at FiO2 > 0.5 (A-a)O2 > 350 mmHg at FiO2 1.0 PaO2/FiO2 < 200
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HypercapnicHypercapnic respiratory failurerespiratory failure
Tidal volume < 5 ml/kg Vital capacity < 10 ml/kg Minute volume < 5 l/min Respiratory rate > 35 /min Breathing pattern : abdominal paradox
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Mechanical ventilationMechanical ventilation
Positive pressure ventilation Tidal volume ( volume target or pressure
target) Respiratory rate
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Normal Respiration : negative Normal Respiration : negative pressure inspirationpressure inspiration
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MV: Positive pressure ventilationMV: Positive pressure ventilation
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Breath typeBreath type
Controlled mandatory breath Assisted mandatory breath Spontaneous breath
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ControlleControlle mandatory breath VS mandatory breath VS Assisted mandatory breathAssisted mandatory breath
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Spontaneous breathSpontaneous breath
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ClassificationClassification
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Phase Variables Phase Variables 4 phase4 phase
1. trigger2. limit3. cycle4. baseline
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Pressure(cmH2O)
1
2
3Expiration phaseInspiration phase
Insp. --> Exp.
4 Exp. --> Insp.
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Ventilator phase variables
Trigger
1. Time-triggered2. Pressure-triggered3. Flow-triggered
1.Volume-cycled
1. Volume-limited
2. Pressure-limited
3. Flow-limited
2.Pressure-cycled3.Time-cycled4. Flow-cycled
Limit Cycle Baseline
1. PEEP +
2. ZEEP 0
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Type of ventilationsType of ventilations
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Conventional mechanical Conventional mechanical ventilationventilation
Fully support ventilations Partial support ventilations
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Fully support ventilationsFully support ventilations
tidal volume respiratory rate Continuous mandatory ventilation (CMV) Assist-controlled mandatory ventilation (ACV) tidal volume volume or pressure Volume control ventilation (VCV, V-ACV) Pressure control ventilation (PCV, P-ACV)
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Continuous Mandatory Ventilation (CMV)Continuous Mandatory Ventilation (CMV)Volume controlVolume control (VCV)(VCV)
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Continuous Mandatory Ventilation (CMV)Continuous Mandatory Ventilation (CMV)Pressure control (PCV)Pressure control (PCV)
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AssistAssist--Control Mandatory Ventilation (ACV), Control Mandatory Ventilation (ACV), Volume control (VVolume control (V--ACV)ACV)
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AssistAssist--Control Mandatory Ventilation (ACV), Control Mandatory Ventilation (ACV), Pressure control (Pressure control (PP--ACV)ACV)
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Partial support ventilationsPartial support ventilations
(spontaneous breath)
Synchronized intermittent mandatory ventilation (SIMV)
Pressure support ventilation (PSV) Continuous positive airway pressure
(CPAP)
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Synchronized Intermittent Mandatory Synchronized Intermittent Mandatory Ventilation (SIMV)Ventilation (SIMV)
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Pressure Support VentilationPressure Support Ventilation(PSV)(PSV)
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SIMV plus PSVSIMV plus PSV
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Continuous Positive Airway Continuous Positive Airway Pressure (CPAP)Pressure (CPAP)
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Initial Setting of Initial Setting of MechanicalMechanical VentilationVentilation
Ventilator setting Recommendation Tidal Volume 8 - 10 ml/Kg Respiratory rate 12 20 breaths/min Flow rate 60 L/min I:E 1 : 2 Flow profile Decelerating wave Sensitivity - 1 to - 2 cmH2O FiO2 0.4 1.0 keep SaO2 > 90% PEEP 3 - 5 cmH2O
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THE ENDTHE END
Basic of Mechanical VentilatorMechanical Ventilators (MV)Indication for mechanical ventilationHypoxic respiratory failureHypercapnic respiratory failureMechanical ventilationNormal Respiration : negative pressure inspirationMV: Positive pressure ventilationBreath type Controlle mandatory breath VS Assisted mandatory breathSpontaneous breathClassification Phase Variables 4 phaseType of ventilationsConventional mechanical ventilationFully support ventilationsContinuous Mandatory Ventilation (CMV)Volume control (VCV)Continuous Mandatory Ventilation (CMV)Pressure control (PCV)Assist-Control Mandatory Ventilation (ACV), Volume control (V-ACV)Assist-Control Mandatory Ventilation (ACV), Pressure control (P-ACV)Partial support ventilationsSynchronized Intermittent Mandatory Ventilation (SIMV)Pressure Support Ventilation(PSV)SIMV plus PSVContinuous Positive Airway Pressure (CPAP)Initial Setting of Mechanical VentilationTHE END