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VENTILATION ‘101’

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  1. VENTILATION ‘101’ Junior Practitioner Learning Package Dr Bronwyn Avard, July 2010

  2. Objectives • To understand the physiological principles underlying mechanical ventilation • To know the different terminology associated with mechanical ventilation

  3. PRE-TEST Please complete pre-test before proceeding with learning package http://www.surveymonkey.com/s/ventilation_juniorpack_pretest

  4. BASIC RESPIRATORY PHYSIOLOGY

  5. POSITIVE PRESSURE VENTILATION

  6. TERMINOLOGY NIV PS CPAP IRV PEEP BiPAP PCV IMV ARV SIMV

  7. Invasive v Noninvasive NON-INVASIVE VENTILATION INVASIVE VENTILATION

  8. Invasive v Noninvasive NON-INVASIVE VENTILATION INVASIVE VENTILATION CPAP BIPAP 10cmH2O PRESSURE 5cmH2O TIME

  9. Invasive v Noninvasive NON-INVASIVE VENTILATION INVASIVE VENTILATION controlled spontaneous volume control pressure control pressure support (SIMV) (PCV) (PS)

  10. Invasive v Noninvasive NON-INVASIVE VENTILATION INVASIVE VENTILATION pressure volume controlled spontaneous controlled (PCV) (PS) (SIMV)

  11. Invasive ventilation • Volume-control ventilation VOLUME TIME

  12. Invasive ventilation • Volume-control ventilation - SIMV VOLUME TIME

  13. Invasive ventilation • Pressure-control ventilation PRESSURE TIME

  14. PEEP 10cmH2O PRESSURE 5cmH2O TIME

  15. Number tricks SET : pressure support 10cmH20 & PEEP 5cmH2O Peak inspiratory pressure  Pressure = 10cmH2O 15cmH2O PRESSURE 5cmH2O TIME PRESSURE SUPPORT

  16. Number tricks SET : pressure support 10cmH20 & PEEP 5cmH2O 20cmH2O  Pressure = 10cmH2O 10cmH2O TIME PRESSURE SUPPORT

  17. Number tricks SET : PIP 15cmH20 & PEEP 5cmH2O  Pressure = 10cmH2O 15cmH2O PRESSURE 5cmH2O TIME PRESSURE CONTROL

  18. Number tricks SET : PIP 15cmH20 & PEEP 10cmH2O 15cmH2O  Pressure = 5cmH2O PRESSURE 5cmH2O TIME PRESSURE CONTROL

  19. Number tricks SET : IPAP 15cmH20 & EPAP 5cmH2O  Pressure = 10cmH2O 15cmH2O PRESSURE 5cmH2O TIME BiPAP

  20. Number tricks SET : IPAP 15cmH20 & EPAP 10cmH2O 15cmH2O  Pressure = 5cmH2O PRESSURE 5cmH2O TIME BiPAP

  21. Other issues • Triggering • Inspiratory time • I:E ratios

  22. Other issues • Triggering • Flow or pressure change • Inspiratory time • I:E ratio

  23. Other issues • Triggering • Inspiratory time • Default 1.7 seconds • Often reduced (1.2 seconds more comfortable) • I:E ratio

  24. Other issues • Triggering • Inspiratory time • I:E ratio • Usually ~1:3 • When adjusting inspiratory time check I:E ratio • Check not accidently ventilating with inspiratory time longer than expiratory time • Disease-specific

  25. Oxygen or Carbon Dioxide? • Oxygenation • FiO2 • PEEP • Carbon dioxide • Respiratory rate • Pressure/volume

  26. POST-TEST http://www.surveymonkey.com/s/ventilation_juniorpack_posttest

  27. The end

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