Ventilatory Modes. Volume Controlled Mandatory Breath Gas is delivered at a constant flow until the set tidal volume is reached. Pressure rises to a.

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Presentation transcript:

Ventilatory Modes

Volume Controlled

Mandatory Breath Gas is delivered at a constant flow until the set tidal volume is reached. Pressure rises to a peak. Inspiration is held for the set inspiratory time. Pressure falls to a plateau. Expiration is passive

Peak Airway Pressure (resistance) Plateau Pressure (P PLAT ) (compliance) Inspiratory Time (T insp ) You can set: Tidal Volume Inspiratory Time Respiratory Rate PEEP

Patient Triggered Breath If the patient begins to breathe, a mandatory breath is triggered. The breath is ‘triggered’ by a pressure drop or a flow.

Intermittent Mandatory Ventilation A circuit that allows the patient to breathe throughout the respiratory cycle. Allows ‘normal’ and not just machine breaths.

Spontaneous InspirationSpontaneous Expiration Mandatory InspirationMandatory Expiration

SIMV (Synchronised Intermittent Mandatory Ventilation) SIMV Cycle = 60/mandatory rate so if mandatory rate = 10 1 cycle = 6s. Every 6s the machine delivers a mandatory breath. That breath may be either patient triggered or not. For the rest of the 6s they can breathe ‘normal’ breaths as much or as little as they want. The ‘normal’ breaths can be pressure assisted or not. (we’ll get to that later)

Pressure Controlled

Mandatory Breath Gas is delivered to a preset pressure, and maintained at that level. Flow falls to stop further rises in pressure. Expiration is passive

Pressure Support (Assisted Spontaneous Breathing) The patient triggers a breath. The gas is then delivered to a preset pressure. Expiration occurs when the insiratory flow has falled by a (default %) – there is no inspiratory pause.

Synchronised Intermittent Mandatory Pressure Ventilation Like SIMV but with pressure controlled breaths. Con be combined with ASB. We call this BIPAP

You can set.. Inspiratory Pressure (P INSP ) Frequency (number of mandatory breaths) PEEP Inspiratory Time (t INSP ) Trigger Pressure Support

BIPAP is actually….. A circuit whereby the patient can breathe at any time. It is effectively CPAP cycling between 2 pressure levels and is a non-invasive mode Flow increases whenever the patient takes a breath.