Ventilators – a basic tutorial What is the point? To provide oxygenation and ventilation. Or to reduce work of breathing. How do you ventilate soeone? !ut air in their lungs" either a se t volue or set pressure. Vocabulary# $. Tidal volu e %. !ress ure sup port – pressu re tha t auge nts a spont aneous breath &. !''! – p ositi ve end e xpira tory pressure. !ress ure th at is ainta ined a t the end of expiration to prevent alveolar collapse. This in effect inc reases copliance" and thus oxygenation. (. )#' ra tio – t he ins pirat ory ti e to e xpir atory t ie ra tio. *ora l is & #$. +. ,$- over +or ,$-/+– 0pres sure support 1 abov e 0!''!1. The as signe d press ure support" which is above and beyond the continuous !''!" for spontaneous breaths. What can we control? $. The aou nt of air w e put into the lu ngs – eith er by volu e 0tida l volue 1 or press ure. We can also control pressure support and !''!. %. Ox ygen – 2iO% &. Ti ing – 3esp irator y r ate. )#' ratio. What can we easure? $. !ressures a. !eak b. !lateau – a eas ure of h ow co pl ian t the lu ng is c. 4tati c 5 0!eak – !l ateau 1. 6 e asure of re sist ance in th e c ircui t. %. 7inute Ventilation 0total volue ventilated in $ inute1 7odes of ventilation – 'ach has distinct advantages and disadvantages. Volue8based ventilation# $. 6ssist89ontrol. a. ,assist– refer s to assis ting a sponta neous breath b. ,cont rol–ref ers to a ful ly cont rolled br eath wi thout spon taneo us effo rt c. 3esul t – There is a basa l rate o f full b reaths " and ea ch spon taneou s breath gets a full volue. %. )7V – interit tent andatory ven til ati on a. ,anda tory – refers to ass igned ra te of fu ll and atory b reaths b. 6ll othe r breat hs are s pontaneous or a ssis ted wi th press ure support c. ,syn chroni :ed– refe rs to syn chroni :ation of andato ry brea ths wit h pt;s diaphrag!ressure8based ventilation# $. !ressure 9ontrol a. 6ss igned rate of fu ll pr essure breaths b. Volues will vary . c. 2l ow r at e wil l va ry . %. !ressure 4upport a. 6ugen ts spont aneous breat hing. Helps overcoe tubing . &. !3V9 – pres sur e regu lat ed volue control
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