![Page 1: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/1.jpg)
How to improve oxygenationwith Conventional Ventilator
Muhammad Asim RanaBSc, MBBS, MRCP, FCCP, EDIC, SF-CCM
Critical Care Medicine King Saud Medical City
Riyadh, KSA
![Page 2: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/2.jpg)
Patient’s Data
• 37 yrs old alcoholic female with history of recurrent gall stones.
• Admitted with pancreatitis• Lipase 1120, Amylase 560.• 5th day developed SOB, worsened so electively
intubated.• FiO2 90%, Sat O2 78%, PaO2 48.
![Page 3: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/3.jpg)
Chest Radiology
![Page 4: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/4.jpg)
You only have Conventional Ventilator!
How can she be helped further to improve Oxygenation?
![Page 5: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/5.jpg)
Modalities to Improve Oxygenation
• Increase Respiratory Rate• Increase PIP• Increase Volume• Increase PEEP• Increase Flow• Increase Inspiratory Time (I:E Ratio)
![Page 6: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/6.jpg)
By Increasing MEAN AIRWAY PRESSURE
Can we say it more logically
![Page 7: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/7.jpg)
Mean Airway PressureIncrease FlowIncrease peak pressureLengthen Inspiratory TimeIncrease RateIncrease PEEP
![Page 8: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/8.jpg)
Pressure
T im e
Increasing Mean Airway Pressure1. Increase flow2. Increase peak pressure3. Lengthen inspiratory time4. Increase PEEP5. Increase Rate
![Page 9: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/9.jpg)
Extra for the Experts
![Page 10: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/10.jpg)
• The pt is on PCV with the following settings PEEP=12, FiO2=1.0, IP=18, PIP=28, Vt=350 ml (down from 450ml) & Slope is set at the slowest possible flow delivery.
• ABG’s on these settings are: • 7.28/49/53 (↓O2 ↑CO2 from previous). • The RT notices that PIP reaches only
23cmH2O. No leaks are found in the system. • What recommendations might be made to
improve this patient’s ABG’s?
![Page 11: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/11.jpg)
Decrease the Rise Time
Better ventilation is actually accomplished by adjusting the slope to achieve a faster pressure delivery and increase the Vt,
The PIP will return to 28 cm H2O and the patient's ABG values will improve without further adjustments
![Page 12: Improving oxygenation with conventional ventilator](https://reader035.vdocuments.us/reader035/viewer/2022070604/545308f2af7959bd2b8b5537/html5/thumbnails/12.jpg)
Thank you