Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure.

Slides:

Advertisements

Similar presentations

Patient – Ventilator Asynchrony

Advertisements

Ventilator waveform analysis: often ignored bedside assessment

Effect of nasal positive expiratory pressure (PEP) on 6-min walk test (6MWT) distance and pre- to post-exercise increase in lung volumes in each individual.

The patient is being ventilated with 2 types of breaths.

The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.

Airway pressure and flow waveforms during constant flow volume control ventilation, illustrating the effect of an end-inspiratory breath-hold. Airway pressure.

Example ventilator screen during nasal neurally adjusted ventilatory assist in a premature neonate (23 weeks gestational age, 560 g) with respiratory distress.

Lung simulator diagram of airway pressure release ventilation (APRV): volume (yellow), lung pressure (white), and flow (orange)/time curve. Lung simulator.

Shape-signal method of triggering combines shape signal (A) and volume (B) methods of triggering. Shape-signal method of triggering combines shape signal.

Even though this patient is undergoing positive-pressure mechanical ventilation, the first 4 breaths have a relatively negative pressure (ie, pressure.

Noninvasive ventilation-neurally adjusted ventilatory assist (NIV-NAVA) where each patient effort is captured but support is insufficient (maximum electrical.

Differences in the distribution of lung densities in a patient with ARDS on a computed tomography scan between supine position (top) and prone position.

A: Pressure (green) and volume (black)/time curve in airway pressure release ventilation (APRV). A: Pressure (green) and volume (black)/time curve in airway.

An example of delayed cycling during pressure-support ventilation of a patient with COPD, on a Puritan Bennett 7200 ventilator, which has a flow-termination.

The third breath has a negative deflection (ie, below PEEP) at the end of the mechanical breath (arrow A) associated with a flow increase (arrow B), indicating.

Recordings of quiet tidal breathing at rest, followed by maximal expiration then inspiration. Recordings of quiet tidal breathing at rest, followed by.

Asynchrony index at baseline and following optimization of pressure support (PS) level (A), and following optimization of mechanical inspiratory time (mechanical.

Example airway pressure and rib-cage impedance in a premature infant supported with the biphasic mode of SiPAP (“sigh” positive airway pressure) from the.

Simulated screenshot of flow starvation in volume control continuous mandatory ventilation. Simulated screenshot of flow starvation in volume control continuous.

Characteristics of a pressure-supported breath.

The peak flows (60 L/min) and flow patterns are the same for all the breaths. The peak flows (60 L/min) and flow patterns are the same for all the breaths.

Comparison of airway pressure release ventilation (APRV) (blue curve) and biphasic positive airway pressure (BIPAP) (black curve). Comparison of airway.

Example of invasive measurement of respiratory pressures.

A: Machine-triggered intermittent mandatory ventilation (IMV) with inadequate patient triggering of mandatory breaths. A: Machine-triggered intermittent.

Interactions among clinician, patient, and ventilator.

Trigger and synchronization windows.

Illustrated here are several features used to determine that the esophageal balloon is correctly placed in the esophagus. Illustrated here are several.

Typical pressure-time curves during forced expiration against an occluded airway in cystic fibrosis (CF) patients and healthy controls. Typical pressure-time.

Top: Stress index (SI) in a patient early in the course of ARDS

Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure.

In this tracing of 30 seconds, 4 breaths are ineffectively triggered (arrows IT) and 7 are effectively triggered. In this tracing of 30 seconds, 4 breaths.

A 2-min recording showing periodic breathing, stable delivered pressure, and fluctuating oxygen saturation in a premature neonate supported by nasal intermittent.

Ineffective efforts and operation of apnea ventilation during pressure control continuous spontaneous ventilation (PC-CSV). Ineffective efforts and operation.

Asynchrony index (%) during invasive and noninvasive ventilation (NIV) relative to leak level. Asynchrony index (%) during invasive and noninvasive ventilation.

Asynchrony index (%) during invasive and noninvasive ventilation (NIV) relative to body weight. Asynchrony index (%) during invasive and noninvasive ventilation.

This tracing depicts 30 seconds of information.

Graphic representation of a dynamic airway pressure scalar during volume control ventilation with a constant inspiratory flow. Graphic representation of.

Schematic drawing of alveolar sizes at upper (A), middle (B), and lower dependent (C) lung regions at end expiration and end inspiration. Schematic drawing.

Effect of respiratory mechanics on cycling of pressure support from inhalation to exhalation. Effect of respiratory mechanics on cycling of pressure support.

In supine obese people, the weight of the abdomen pushes against the diaphragm, causing a cranial displacement of the muscle. In supine obese people, the.

Flow, esophageal pressure, airway pressure, and transpulmonary pressure can be used to calculate respiratory system compliance, chest-wall compliance,

We connected the supplemental oxygen supply at 3 places: near the ventilator, near the exhalation valve, and on the nasal mask port. We connected the supplemental.

Control circuit for an adaptive pressure targeting scheme (eg, Pressure Regulated Volume Control). Control circuit for an adaptive pressure targeting scheme.

Static pressure-volume curve from a patient with ARDS showing the lower inflection point (LIP) on the inflation limb signifying the beginning of significant.

Electrical impedance tomographic (EIT) images are created using a series of electrodes placed across the chest, each of which send and receive electrical.

Assembly used to convert a standard ventilator to an intermittent mandatory ventilation circuit. Assembly used to convert a standard ventilator to an intermittent.

Control circuit for a servo targeting scheme (eg, Proportional Assist Ventilation). Control circuit for a servo targeting scheme (eg, Proportional Assist.

Change in trigger delay during invasive (A) and noninvasive ventilation (B) with variable leak. Change in trigger delay during invasive (A) and noninvasive.

A: Pressure ulcer on the left cheek of a patient after 1 week of prone positioning using a commercially available endotracheal tube (ETT) holder. A: Pressure.

A: Functional electrical impedance tomographic tidal image of a patient with a pneumothorax. A: Functional electrical impedance tomographic tidal image.

Total drug dose by device and condition while delivering 1 mL of ribavirin (5 min for the small-particle aerosol generator [SPAG] or 2 min for the vibrating.

Experimental setup of particle distribution using the 8-stage Andersen cascade impactor and in vitro module using an absolute filter. Experimental setup.

The cause of asynchrony during volume-targeted ventilation and total asynchrony index. The cause of asynchrony during volume-targeted ventilation and total.

SpO2 at baseline, pre- and post-intubation.

Graphical representation of the locations where spontaneous breaths may occur during the airway pressure (Paw) release ventilation ventilatory cycle. Graphical.

Mean inspiratory work of breathing during assisted breaths and spontaneous breaths across the spectrum of ventilatory support continuous mandatory ventilation.

Flow, airway pressure, and transversus abdominis electromyogram (EMG) waveforms from a mechanically ventilated patient with COPD receiving pressure-support.

Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. Schematic of mechanisms behind the better recruitment of alveoli.

Components of a patient-triggered mechanical breath.

FEV1 and FVC for the control group (without noninvasive ventilation [NIV]), NIV with an inspiratory pressure (IPAP) of 15 cm H2O and expiratory pressure.

Determinants of patient-ventilator interaction.

Correlation between maximum inspiratory pressure and inspiratory load compensation (ILC) ventilatory variables in the 16 difficult-to-wean subjects, prior.

Airway pressure and flow graphics illustrate delayed cycling.

The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.

For inspiratory load compensation testing, this threshold positive expiratory pressure (PEP) training device was inverted and connected to a respiratory.

Enhancing flow synchrony with a variable flow, pressure-targeted breath. Enhancing flow synchrony with a variable flow, pressure-targeted breath. In the.

Lung model expiratory CO2 (or PETOv2) representing simulated alveolar CO2 at baseline (no high-flow nasal cannula) and effect on expiratory CO2 at different.

Fentenyl and lorazepam use for the first 5 d of ventilatory support are presented. Fentenyl and lorazepam use for the first 5 d of ventilatory support.

Minute-by-minute means of breathing variables during the spontaneous breathing trial for the groups of subjects with trial success (n = 32) and failure.

Effects of an automated endotracheal-tube-compensation system on a pressure-support breath. Effects of an automated endotracheal-tube-compensation system.

Presentation transcript:

Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure curve (grey) if the patient was on neurally adjusted ventilatory assist (NAVA), with a preset NAVA level not shown. Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure curve (grey) if the patient was on neurally adjusted ventilatory assist (NAVA), with a preset NAVA level not shown. Breath 3 demonstrates expiratory timing asynchrony: there is continued mechanical inflation after the start of the neural expiration, causing a delay between the neural expiration and the mechanical deflation. Walter Verbrugghe, and Philippe G Jorens Respir Care 2011;56:327-335 (c) 2012 by Daedalus Enterprises, Inc.