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Adhrie Sugiarto
What is a breath?
• A breath is one cycle of positive flow (inspiration) and negative flow
(expiration)
1 breath cycle
Types of breath
• Spontaneous breath arises without apparent external cause. It is
patient triggered and patient cycled
• Mandatory breaths, are breaths with machine involvement in
triggering or cycling
• A breath is assisted if pressure rises above baseline during inspiration
or falls during expiration. A ventilator assists breathing by doing some
portion of the work of breathing.
Assist-Control Mode
• Mode for which the ventilator controls the timing, the cycling, the
tidal volume, or the inspiratory pressure
Assist-Control Mode
Assist-Control Mode
Volume Control
Volume Control
• The volume A/ C mode is intended for ventilated patients who are
passive or partially active
• The volume assist/ control mode allows the operator to directly
control tidal volume, rate, and Ti for a desired minute volume
Volume Control
In this mode, the operator sets:
a. Tidal volume
b. Rate
c. Ti (or I:E ratio or peak flow)
d. Patient trigger type and sensitivity
e. PEEP (positive end- expiratory pressure)
f. FiO2
g. Flow pattern (possibly).
Tidal volume and Respiratory rate
• Based on predicted body weight (PBW)
• Males = 50 + 2.3 [height (inches) - 60]
• Females = 45.5 + 2.3 [height (inches) -60]
• Tidal volume 6-8 ml/kg PBW
Time
Setting I:E, inspiratory flow time,
pause time
• Nomenclature
Inspiratory flow time
Volume
Time
Setting I:E, inspiratory flow time,
pause time
• Nomenclature
Inspiratory pause time
Volume
Time
Setting I:E, inspiratory flow time,
pause time
• Nomenclature
Inspiratory time
Volume
Time
Setting I:E, inspiratory flow time,
pause time
• Nomenclature
Inspiratory time Expiratory time
Volume
Time
Setting I:E, inspiratory flow time,
pause time
• Nomenclature
Respiratory cycle time
Volume
Time
I:E as a ratio & inspiratory pause
time as a percentage
6 secs
2 secs 4 secs
10%
Volume
1 2
Respiratory rate
10%
Volume
Inspiratory flow
0.5 s
Volume
1.5 s
Volume
0.5 s
Volume
2 sec 4 sec
0.5 s
Volume
0.3 s
Volume
Time
Increased spontaneous breathing
Exp
time
Volume Inverse ratio
Time
Calculating adequate flow
Pressure
Flow
Volume
Time
Disadvantages of Pressure Control
• The perceived disadvantage of this mode is that an operator cannot
directly control tidal volume.
• The resultant tidal volume may be unstable when the patient’s
breathing effort and/ or respiratory mechanics change. Therefore, you
should carefully set the upper and lower limits of the tidal volume
alarm
Assist-Control Mode
Thank You