1、Waveform Monitoring of the Mechanically Ventilated Patient,Tim Opt Holt, Ed.D., R.R.T. Professor Cardiorespiratory Care University of South Alabama,How ventilator works?,Basic Concepts,Resistance = Pressure / FlowCompliance = Volume / PressureFlow = Volume / Time,Objectives,Describe the volume, pres
2、sure and flow versus time scalars. Describe the use of scalars in the management of the mechanically ventilated patient. Describe the flow-volume and pressure-volume loops as they are used in the mechanically ventilated patient. Describe how loops are used to diagnose and manage problems in patients
3、 receiving mechanical ventilation,Monitoring Techniques Used During Mechanical Ventilation,Ventilator waveforms pressure, volume and flow vs time scalars flow-volume and pressure volume loops Allows analysis of auto-PEEP, bronchodilator response, hyper- expansion, adequacy of flow, ventilator sensit
4、ivity, compliance, and leaks,Ventilator Waveforms,Scalars Volume versus time Pressure versus time Flow versus time Loops Flow-Volume Pressure -Volume,Flow versus Time,ACCELERATING,DECELERATING,SINE,SQUARE,Volume vs Time,Inspiration,Expiration,Time (sec),Volume (ml),TI,Pressure versus Time,Inspiratio
5、n,Expiration,Paw (cm H2O),Time (sec),TI,TE,Pressure-Volume Loop,Controlled,Assisted,Spontaneous,Vol (ml),Paw(cm H2O),I: Inspiration E: Expiration,I,E,E,E,I,I,Flow-Volume Loop,Volume (ml),PEFR,FRC,Inspiration,Expiration,Flow (L/min),PIFR,VT,Pathological Conditions,Air trapping and auto-PEEP,Air Trapp
6、ing,Inspiration,Expiration,Time (sec),Flow (L/min),Air Trapping,Inspiration,Expiration,Volume (ml),Flow (L/min),Does not return to baseline,Normal Abnormal,Pathological Conditions,Increased airway resistance,Paw (cm H2O),Normal PPlat (Normal Compliance),Increased PIP,Increased PTA (increased Airway
7、Resistance),Increased Airway Resistance,Increased Airway Resistance,Inspiration,Expiration,Volume (ml),Flow (L/min),Decreased PEFR,Normal Abnormal,“Scooped out”pattern,Pathological Conditions,Response to Bronchodilator,Response to Bronchodilator,Before,Time (sec),Flow (L/min),PEFR,After,Long TE,High
8、er PEFR,Shorter TE,Pathological Conditions,Overdistension,Overdistension,Volume (ml),Pressure (cm H2O),With little or no change in VT,Paw rises,Normal Abnormal,Pathological Conditions,Inadequate Inspiratory Flow(Air Hungary),Inadequate Inspiratory Flow,Adequate Flow,Time (sec),Inadequate Flow,Paw (c
9、m H2O),Inadequate Inspiratory Flow,Flow (L/min),Time (sec),Normal Abnormal,Active Inspiration or Asynchrony,Pathological Conditions,Inadequate Sensitivity,Inadequate Sensitivity,Volume (mL),Paw (cm H2O),Increased WOB,Pathological Conditions,Decreased Compliance,DECREASED COMPLIANCE,Time (sec),Paw (c
10、m H2O),Normal PPlat (Normal Compliance),Increased PPlat (Decreased Compliance),Normal,PIP,Lung Compliance Changes and the P-V Loop,Volume (mL),Preset PIP,VT levels,Paw (cm H2O),COMPLIANCE Increased Normal Decreased,Pressure Targeted Ventilation,Pathological Conditions,Air Leak,Air Leak,Volume (ml),Time (sec),Air Leak,Volume (ml),Pressure (cm H2O),Air Leak,Air Leak,Inspiration,Expiration,Volume (ml),Flow (L/min),Air Leak in mL,Normal Abnormal,Thanks,【更多精品】狂点,感谢阅读,
