Académique Documents
Professionnel Documents
Culture Documents
2
The Four Phases of Breath
1 2 3 4 Phases of Breath
Flow
Time
3
Inspiratory Trigger
• Manual Button
User Inisiatif (Begging) / Inspiratory Hold
• Machine Inisiatif
RR Setting, Periodically every 60/RR second
(Ex : RR=10, Triggered Periodically ever y 6 second)
• Patient Inisiatif
Trigger Sensitivity Setting : Pressure or Flow Trigger
(Ventilator Sensitivity in detecting Patient’s Triggers)
4
Inspiratory Trigger
Patient Trigger Pressure vs Flow Trigger
• P-trigger (minus, cmH2O)
• Sensitive, but may be affected by noise (self-cycling)
• Any associated base-flow, intrinsic PEEP or Deadspace
worsens the performance (Increased WOB in triggering)
• F-trigger (liter/min)
• More Sensitive, and only rarely affected by noise
• Any associated base-flow improves the performance
but need Leakage Identification and Compensation
5
Inspiration
• Volume Breath
• Tidal Volume (Square Flow x Ti)
• Pressure Breath
• Pressure Inspirasi (Nilai diatas 0) atau
• Pressure Control (Pinsp = PEEP + PC) atau
• Pressure Support (PASB = PEEP + PS)
6
Cycling
7
Expiration
8
9
Patient’s Breath
(from Apnea to Spontaneous Breath)
10
Ventilation Modes/Parameter following
the Patient’s Spontaneous Breath
11
Controlled Ventilation Modes
12
Intermittent Ventilation Modes
Intermittent Modes :
Trigger Sensitivity = SET All patient’s Trigger will be Supported with Pressure Support (PS) Breath
Intermittent Modes is combination of Controlled Breath (VT or Pinsp) and Supported Breath (PS)
13
Spontaneous Ventilation Modes
Spontaneous Modes :
No Controlled Breath (VT or Pinsp) will be given
Trigger Sensitivity = SET All patient’s Trigger will be Supported with Pressure Support
14
Ventilation Graph
Perbandingan Mode Full Control, Assist Control, Intermittent & CPAP/ASB
15
Ventilation Setting & Graph
OR
16
Ventilation Graph
Mandatory & Assisted Breathing Comparison
17
Ventilation Graph
Assisted & Supported Breathing Comparison
18
Ventilation Graph
Perbandingan Mode Full Control, Assist Control, Intermittent & CPAP/ASB
19
Draeger Ventilation Modes
20
Waveform
21
22
23
24
Resistance & Compliance
AIRWAY
Resistensi Compliance
Pressure
Penurunan Peningkatan
Peak
Resistensi Compliance
Kolaps/
Atelektasis P
25
Compliance – Pressure & Volume Correlation
T T
P P
T T
Peningkatan Compliance
Peningkatan Volume pd Pressure yg sama
Penurunan Pressure pd Volume yg sama
Penurunan Compliance
Penurunan Volume pd Pressure yg sama
Peningkatan Pressure pd Volume yg sama
26
Free Breathing with PCV+ (BIPAP) and AutoFlow®
27
CPAP Concept :
Free Breathing on PEEP/CPAP Level
28
Inspiratory Phase on
Conventional PCV VS PCV+ (BIPAP)
29
Conventional PCV VS PCV+ (BIPAP)
30
Pressure & Volume Modes
31
Dual Control Modes
(Conventional)
32
Volume Modes with AutoFlow
33
Terima Kasih
34