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

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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.
Trigger pressure-time product (PTP) with zero pressure support, with no leak, medium leak, and large leak. Trigger pressure-time product (PTP) with zero.
Relationship between the recruited volume and the arithmetic mean of the ratios of lung density at PEEP 15 cm H2O to lung density at PEEP 5 cm H2O (μP15/P5)
Example ventilator screen during nasal neurally adjusted ventilatory assist in a premature neonate (23 weeks gestational age, 560 g) with respiratory distress.
Lung CT images were obtained while tracing the curve in static conditions. Lung CT images were obtained while tracing the curve in static conditions. Note.
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.
Cuff-pressure changes after the addition of 5 mL and 10 mL of air into the cuff of 3 artificial airways, after initial baseline of 30 cm H2O established.
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.
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.
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.
Indications for ventilation in adults
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.
During this tracing of 30 seconds, the ventilator displays that the patient rate is 16 breaths/min. During this tracing of 30 seconds, the ventilator displays.
Comparison of airway pressure release ventilation (APRV) (blue curve) and biphasic positive airway pressure (BIPAP) (black curve). Comparison of airway.
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.
Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure.
Pressure, flow, volume, and electrical activity of the diaphragm (EAdi) waveforms from a patient on pressure support ventilation, and the presumed pressure.
Algorithm of the typical evolution of disease in patients with progressive neuromuscular disorders (gray boxes) and assessments and interventions that.
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Work rate as a function of pressurization rate and cycling-off threshold, during pressure-support ventilation of (A) patients with acute lung injury (ALI),
Effect of respiratory mechanics on cycling of pressure support from inhalation to exhalation. Effect of respiratory mechanics on cycling of pressure support.
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Flow, esophageal pressure, airway pressure, and transpulmonary pressure can be used to calculate respiratory system compliance, chest-wall compliance,
Esophageal pressure, airway pressure, and transpulmonary pressure (PL) with PEEP set at 26 cm H2O (same patient as Fig. 24). Esophageal pressure, airway.
Negative pressures calculated with the Rosen and Hillard formula
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Blom speech cannula. Blom speech cannula. Inspiratory pressure opens the flap valve and closes (expands) the bubble valve, sealing the fenestration so.
Carbon monoxide (CO) delivery system used in animal models and Phase 1 clinical trials. Carbon monoxide (CO) delivery system used in animal models and.
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The Boussignac continuous positive airway pressure (CPAP) is a small plastic cylinder that attaches to a face mask. The Boussignac continuous positive.
Effects of increasing the cycling-off threshold according to prolonged (A) or short (B) time constant of the respiratory system. Effects of increasing.
Assembly used to convert a standard ventilator to an intermittent mandatory ventilation circuit. Assembly used to convert a standard ventilator to an intermittent.
A novel multi-channeled neonatal patient Y-piece device (AFECTAIR) developed as part of an aerosolized lung surfactant administration system to be used.
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.
Graphical representation of the locations where spontaneous breaths may occur during the airway pressure (Paw) release ventilation ventilatory cycle. Graphical.
Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. Schematic of mechanisms behind the better recruitment of alveoli.
Plots of alveolar PO2, hemoglobin saturation, and alveolar PCO2 as a function of alveolar ventilation in a normal subject at sea level (inspired oxygen.
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.
Ventilation protocol. Ventilation protocol. The PEEP group raised peak inspiratory pressure (PIP) through 5-cm H2O PEEP increments every 2 min while keeping.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) ABCD scheme for classifying patients with COPD with separate appraisal of air-flow limitation.
Inspiratory load compensation responses before and after inspiratory muscle strength training (IMST) in the unweaned versus weaned subjects, with a 10.
Depiction of an expiratory flow curve.
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.
Experimental setup. Experimental setup. Each tested ventilator was connected to the TTL test lung via a ventilator circuit. An oxygen analyzer, a pressure.
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.
Average drug doses in the peripheral lung, central lung, and extrathoracic airway; residual drug left in the device; and residual drug that was exhaled.
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.
Representative waveforms for each of the devices tested from which the oscillatory f was counted. Representative waveforms for each of the devices tested.
Presentation transcript:

Flow, airway pressure, and transversus abdominis electromyogram (EMG) waveforms from a mechanically ventilated patient with COPD receiving pressure-support ventilation at 20 cm H2O. Flow, airway pressure, and transversus abdominis electromyogram (EMG) waveforms from a mechanically ventilated patient with COPD receiving pressure-support ventilation at 20 cm H2O. The onset of expiratory muscle activity (vertical dotted line) occurred when mechanical inflation was only partly completed, as indicated by the onset of expiratory muscle activity. Active exhalation caused an increase in airway pressure at end-exhalation, causing the ventilator to pressure-cycle rather than flow-cycle. (Adapted from Reference 29, with permission.)‏ Michael A Gentile Respir Care 2011;56:52-60 (c) 2012 by Daedalus Enterprises, Inc.