CLINICAL UTILITY OF VENTILATOR GRAPHICS

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Presentation transcript:

CLINICAL UTILITY OF VENTILATOR GRAPHICS Vijay Deshpande, MS, RRT, FAARC Assistant Professor, Georgia State University Atlanta, Georgia. Essential of ventilator graphics.

TYPES OF WAVEFORMS There are two types of ventilator waveforms: scalars and loops Scalars are tracings of three parameters: pressure, volume and flow against time. - Flow vs Time ( type of flow pattern) - Pressure vs. Time: clinically very important waveform - Volume vs. Time: volume delivered to the patient Loops pressure vs. volume and, flow vs. volume.

Auto-PEEP or air trapping Inadequate expiratory time Too high a respiratory rate Long Inspiratory Time Prolonged exhalation due to bronchoconstriction A higher inspiratory flow rate (in volume-cycled ventilators) or short TI (in time-cycled ventilators) allows for a longer TE and may eliminate auto-PEEP

Components of Pressure-Time Curve Plateau Pressure ( Pplat ) or Alveolar Pressure Inflation Hold or Inspiratory Pause control. the plateau pressure is the same as the alveolar pressure. Transairway Pressure (PTA = PIP – Pplat ) the pressure required to overcome airway resistance. Bronchospasm, airway secretions, and other types of airway obstructions (PIP-Pplat). Cs = VT P plat - PEEP

PIP, Pplat , PTA, and TI.

Inspiratory Tidal Volume Inspiratory Phase Expiratory Phase Inspiratory Time

abnormalities in flows associated with obstruction.

ARDS on a volume-targeted mode switch to pressure targeted ventilation, or a reduction in VT . ARDS on a volume-targeted mode

PIFR, PEFR Tidal Volume End of Expiration and Beginning of Inspiration

Flow limited, time triggered, volume cycled ventilation

Flow limited, patient triggered, volume cycled ventilation