Principles of Mechanical Ventilation: A Graphics-Based Approach

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Principles of Mechanical Ventilation: A Graphics-Based Approach"

Transcription

1 Principles of Mechanical Ventilation: A Graphics-Based Approach Steven M. Donn, MD, FAAP Professor of Pediatrics Neonatal-Perinatal Medicine C.S. Mott Children s Hospital University of Michigan Health System

2 DATA

3

4

5

6

7

8

9 The Importance of Graphics

10 Why is it Important? Assists in optimizing mechanical ventilation parameters (PIP, PEEP, Ti, tidal volume, flow rate) Allows evaluation of spontaneous respiratory effort and interaction with the ventilator Determines infant s response to pharmacologic agents (surfactant, diuretics, steroids, bronchodilators) Trends monitored events and ventilator parameters over time

11 Basic Principles Oxygenation is proportional to mean airway pressure (PIP, PEEP, Ti, and rate) Ventilation is proportional to the product of frequency and Vt (amplitude, or PIP-PEEP) In CMV, carbon dioxide removal = f X Vt In HFV, carbon dioxide removal = f X (Vt) 2

12 Ways to increase Mean Paw 20 Pressure (cm H 2 O) Increase PIP 2. Increase PEEP 3 3. Increase I-time 4. Increase flow rate (5. Increase vent rate) 2 Ti Te Ti Time (sec)

13 Overview Pulmonary waveforms Pressure waveform Flow waveform Volume waveform Pulmonary loops and mechanics Pressure-volume loop Flow-volume loop

14 Pulmonary Waveforms Pressure vs Time Flow vs Time Volume vs Time Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

15 Pressure Waveform Area under the curve = mean airway pressure Inspiration(red) Expiration(blue) PIP Ti PEEP Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

16 Flow Waveform Inspiratory phase(positive) Peak inspiratory flow Accelerating flow Expiratory phase(negative) Peak expiratory flow Decelerating flow Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

17 Flow Waveform Gas Trapping Before the decelerating expiratory waveform reaches baseline(0 flow), the accelerating inspiratory flow wave of the next breath begins(below 0 flow) Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

18 Flow Waveform Distinguishing Breath Types Sinusoidal wave form seen in pressure ventilation Square waveform seen in volume ventilation Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

19 Flow Waveform Expiratory Resistance Lower resistance has a steeper decelerating expiratory waveform Sinha SK, Nicks JJ, Donn SM. Graphic analysis of pulmonary mechanics in neonates receiving assisted ventilation. Arch Dis Child Fetal Neonatal Ed 1996; 75: F213-F218.

20 Flow Waveform - Turbulence Noisy appearance of the waveform Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

21 Volume Waveform Similar to the previously viewed pressure waveform with the exception that the volume waveform should start and end at a baseline of 0 volume Inspiration(red) Expiration(blue) Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

22 Autocycling Rhythmic breaths without a pause and a large ETT leak shown by the expiratory volumes not returning to baseline (0 volume) Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

23 Pressure-Volume Loop Volume Expiration PIP Pressure Inspiration PEEP Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

24 Pressure-Volume Loop Compliance = Volume Pressure Good compliance will have a compliance axis >45 if axes are properly scaled. Compliance Axis Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

25 Pressure-Volume Loop - Compliance Poor compliance Good compliance Slope ~30 Slope ~45 Sinha SK, Nicks JJ, Donn SM. Graphic analysis of pulmonary mechanics in neonates receiving assisted ventilation. Arch Dis Child Fetal Neonatal Ed 1996; 75: F213-F218

26 Pressure-Volume Loop Inadequate PEEP Delay in volume delivery despite increasing pressure, indicating suboptimal opening pressure Sinha SK, Nicks JJ, Donn SM. Graphic analysis of pulmonary mechanics in neonates receiving assisted ventilation. Arch Dis Child Fetal Neonatal Ed 1996; 75: F213-F218

27 Pressure-Volume Loop Lung Overinflation Flattening of the volume curve indicates: -The ventilator delivers volume that is in excess of lung capacity -Excessive pressure without an increase in volume This can be numerically depicted by using the C20/C as shown. Figure courtesy of Dr. Mark Mammel

28 Pressure-Volume Loop Lung Overinflation Image at:

29 Pressure-Volume Loop Inadequate Flow Inadequate flow as evidenced by: -Narrow loop -Little separation between the inspiratory and expiratory limbs - Figure 8 appearance at the end of inspiration Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

30 Flow-Volume Loop Peak inspiratory flow Flow Inspiration(positive) Expiration(negative) Volume Peak expiratory flow Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

31 Flow-Volume Loop - Resistance Increased resistance(lower peak inspiratory and expiratory flows) Decreased resistance(higher peak inspiratory and expiratory flows) Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

32 Flow-Volume Loop ETT Leak The expiratory flow loop does not reach the origin Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

33 Flow-Volume Loop - Turbulence Noisy appearance of the loops Becker MA, Donn SM. Real-time pulmonary graphic monitoring. Clin Perinatol 2007; 34: 1-17

34 Time Constant Time constant (sec) = Resistance (cm H 2 O/L/sec) X Compliance (L/cm H 2 0) One time constant is defined as the time necessary for alveolar pressure to reach 63% of the change in airway pressure.

35 Time Constant % 95% 98% 99% Change in Pressure (%) % Time Constants

36 Time Constant: Healthy Infant Resistance = 30 cm H 2 O/L/sec x Compliance = L/cm H 2 O Time Constant = 0.12 sec For near complete equilibration (5 TC) = 5 x 0.12 sec = 0.6 sec

37 Time Constant: RDS Resistance = 100 cm H 2 O/L/sec x Compliance = L/cm H 2 O Time Constant = 0.05 sec For near complete equilibration (5 TC) = 5 x 0.05 sec = 0.25 sec Lungs with decreased compliance will complete inflation & deflation quicker

38 Time Constant Time constant becomes critical when Ti or Te is so short that it is insufficient for pressure equilibration. If Ti is too short (<5 TC) incomplete tidal volume may be delivered If Te is too short (<5 TC) Incomplete expiration Increase in FRC Inadvertent PEEP

39 Practical Hints Make sure graphs are properly scaled - P and V axes should be equal - Wave forms should not be off scale Check for leaks, condensation, and secretions When all else fails, LOOK AT THE BABY!

40 Pulmonary Graphics You can observe a lot by watching. -Yogi Berra

RESPIRATORY PHYSIOLOGY, PHYSICS AND PATHOLOGY IN RELATION TO ANAESTHESIA AND INTENSIVE CARE

RESPIRATORY PHYSIOLOGY, PHYSICS AND PATHOLOGY IN RELATION TO ANAESTHESIA AND INTENSIVE CARE Course n : Course 3 Title: RESPIRATORY PHYSIOLOGY, PHYSICS AND PATHOLOGY IN RELATION TO ANAESTHESIA AND INTENSIVE CARE Sub-category: Intensive Care for Respiratory Distress Topic: Pulmonary Function and

More information

Principles of mechanical ventilation. Anton van Kaam, MD, PhD Emma Children s Hospital AMC Amsterdam, The Netherlands

Principles of mechanical ventilation. Anton van Kaam, MD, PhD Emma Children s Hospital AMC Amsterdam, The Netherlands Principles of mechanical ventilation Anton van Kaam, MD, PhD Emma Children s Hospital AMC Amsterdam, The Netherlands Disclosure Research grant Chiesi Pharmaceuticals Research grant CareFusion GA: 27 weeks,

More information

Pressure Controlled Modes of Mechanical Ventilation

Pressure Controlled Modes of Mechanical Ventilation Pressure Controlled Modes of Mechanical Ventilation Christopher Junker Department of Anesthesiology & Critical Care Medicine George Washington University Saturday, August 20, 2011 Assist Control Hypoxemic

More information

SLE5000 Infant Ventilator with HFO

SLE5000 Infant Ventilator with HFO SLE5000 Infant Ventilator with HFO When the smallest thing matters SLE5000 - The Total Solution for Infant Ventilation Shown on optional roll stand. Ventilator may be mounted either way round on stand.

More information

UNDERSTANDING NEONATAL WAVEFORM GRAPHICS. Brandon Kuehne, MBA, RRT-NPS, RPFT Director- Neonatal Respiratory Services

UNDERSTANDING NEONATAL WAVEFORM GRAPHICS. Brandon Kuehne, MBA, RRT-NPS, RPFT Director- Neonatal Respiratory Services UNDERSTANDING NEONATAL WAVEFORM GRAPHICS Brandon Kuehne, MBA, RRT-NPS, RPFT Director- Neonatal Respiratory Services Disclosures Purpose: To enhance bedside staff s knowledge of ventilation and oxygenation

More information

Mechanical Ventilation. Flow-Triggering. Flow-Triggering. Advanced Concepts. Advanced Concepts in Mechanical Ventilation

Mechanical Ventilation. Flow-Triggering. Flow-Triggering. Advanced Concepts. Advanced Concepts in Mechanical Ventilation Mechanical Ventilation Advanced Concepts in Mechanical Ventilation Flow-Triggering Trigger = the variable that causes the vent to begin the inspiratory phase Common triggers 1-2- 3- Effort required to

More information

Selecting the Ventilator and the Mode. Chapter 6

Selecting the Ventilator and the Mode. Chapter 6 Selecting the Ventilator and the Mode Chapter 6 Criteria for Ventilator Selection Why does the patient need ventilatory support? Does the ventilation problem require a special mode? What therapeutic goals

More information

Mechanical Ventilation

Mechanical Ventilation Mechanical Ventilation Understanding Modes Rob Chatburn, RRT-NPS, FAARC Research Manager Respiratory Therapy Cleveland Clinic Associate Professor Case Western Reserve University 1 Overview Characteristics

More information

Mechanical Ventilation

Mechanical Ventilation Mechanical Ventilation Chapter 4 Mechanical Ventilation Equipment When providing mechanical ventilation for pediatric casualties, it is important to select the appropriately sized bag-valve mask or endotracheal

More information

Using Common Ventilator Graphics to Provide Optimal Ventilation

Using Common Ventilator Graphics to Provide Optimal Ventilation Using Common Ventilator Graphics to Provide Optimal Ventilation David Vines, MHS, RRT, FAARC Associate Professor Chair / Program Director Department of Respiratory Care RUSH UNIVERSITY MEDICAL CENTER Disclosure

More information

MEDICAL EQUIPMENT IV MECHANICAL VENTILATORS. Prof. Yasser Mostafa Kadah

MEDICAL EQUIPMENT IV MECHANICAL VENTILATORS. Prof. Yasser Mostafa Kadah MEDICAL EQUIPMENT IV - 2013 MECHANICAL VENTILATORS Prof. Yasser Mostafa Kadah Mechanical Ventilator A ventilator is a machine, a system of related elements designed to alter, transmit, and direct energy

More information

PERFORMANCE EVALUATION #34 NAME: 7200 Ventilator Set Up DATE: INSTRUCTOR:

PERFORMANCE EVALUATION #34 NAME: 7200 Ventilator Set Up DATE: INSTRUCTOR: PERFORMANCE EVALUATION #34 NAME: 7200 Ventilator Set Up DATE: 1. **Identify and name the filters on the 7200ae. 2. **Explain how each filter is sterilized. 3. **Trace the gas flow through the ventilator

More information

Panther 5 Acute Care Ventilator

Panther 5 Acute Care Ventilator 1 HIGHLIGHTS High performance and advanced features target the ICU environment Utilizes an internal blower with a specially designed flow control valve removing the need for using compressed air without

More information

SLE4000. Infant Ventilator with touch-screen operation. When the smallest thing matters

SLE4000. Infant Ventilator with touch-screen operation. When the smallest thing matters SLE4000 Infant Ventilator with touch-screen operation When the smallest thing matters SLE4000 - The Total Solution for Conventional Infant Ventilation SLE is a world leader in the design and manufacture

More information

SLE5000 Neonatal Ventilator with High Frequency Oscillation

SLE5000 Neonatal Ventilator with High Frequency Oscillation SLE5000 Neonatal Ventilator with High Frequency Oscillation The SLE5000 is superb: the best High Frequency Ventilator I ve used When the smallest thing matters SLE5000 - The Total Solution for Infant Ventilation

More information

Initiation and Management of Airway Pressure Release Ventilation (APRV)

Initiation and Management of Airway Pressure Release Ventilation (APRV) Initiation and Management of Airway Pressure Release Ventilation (APRV) Eric Kriner RRT Pulmonary Critical Care Clinical Specialist Pulmonary Services Department Medstar Washington Hospital Center Disclosures

More information

The Crossvent 2i+ 2. Ventilator Concept (brief theory of operation and features)

The Crossvent 2i+ 2. Ventilator Concept (brief theory of operation and features) The Crossvent 2i+ 1. How is this ventilator classified 2. Ventilator Concept (brief theory of operation and features) -Your Two Choices with this Ventilator 3. An overview of the device (an in-service)

More information

RESPIRATORY PHYSIOLOGY RELEVANT TO HFOV

RESPIRATORY PHYSIOLOGY RELEVANT TO HFOV RESPIRATORY PHYSIOLOGY RELEVANT TO Physiology of CMV 1 What is? Ventilation using a relatively high continuous distending pressure at the airway opening, around which an oscillatory wave is generated to

More information

HIGH FREQUENCY JET VENTILATION (HFJV): EQUIPMENT PREPRATION

HIGH FREQUENCY JET VENTILATION (HFJV): EQUIPMENT PREPRATION POLICY The physician orders High Frequency Jet Ventilation (HFJV). The Respiratory Therapist in discussion with the physician will determine blood gas targets and ventilation settings for the treatment

More information

Unit 15 Manual Resuscitators

Unit 15 Manual Resuscitators 15-1 Unit 15 Manual Resuscitators GOAL On completion of this unit, the student should comprehend the proper operation of self-inflating resuscitation bags, flow-inflating resuscitation bags and gas-powered

More information

Ventilators. Dr Simon Walton Consultant Anaesthetist Eastbourne DGH KSS Basic Science Course

Ventilators. Dr Simon Walton Consultant Anaesthetist Eastbourne DGH KSS Basic Science Course Ventilators Dr Simon Walton Consultant Anaesthetist Eastbourne DGH KSS Basic Science Course Objectives Discuss Classification/ terminology Look at Modes of ventilation How some specific ventilators work

More information

The secret of harmonious breathing BABYLOG 8000 PLUS

The secret of harmonious breathing BABYLOG 8000 PLUS D-19679-2015 The secret of harmonious breathing BABYLOG 8000 PLUS 02 The product of expertise and experience More than 40 years of experience in neonatal ventilation and a century of expertise in breathing

More information

Classification of Mechanical Ventilators

Classification of Mechanical Ventilators Classification of Mechanical Ventilators Kacmarek s 12 Point Classification Positive/Negative Pressure Powering Mechanism Driving Mechanism Single or Double Circuited Modes of Ventilation Cycling Parameter

More information

Inspiration 7i Ventilator

Inspiration 7i Ventilator Inspiration 7i Ventilator Clinician Focused Products is not just a tag line, rather a belief system. Low cost of ownership High performance PSOL and active exhalation Comprehensive graphics and trending

More information

Indications for Mechanical Ventilation. Mechanical Ventilation. Indications for Mechanical Ventilation. Modes. Modes: Volume cycled

Indications for Mechanical Ventilation. Mechanical Ventilation. Indications for Mechanical Ventilation. Modes. Modes: Volume cycled Mechanical Ventilation Eric A. Libré, MD VCU School of Medicine Inova Fairfax Hospital and VHC Indications for Mechanical Ventilation Inadequate ventilatory effort Rising pco2 with resp acidosis (7.25)

More information

The secret of harmonious breathing BABYLOG 8000 PLUS

The secret of harmonious breathing BABYLOG 8000 PLUS MT-1166-2005 The secret of harmonious breathing BABYLOG 8000 PLUS 02 The product of expertise and experience More than 30 years of experience in neonatal ventilation and a century of expertise in breathing

More information

QUICK REFERENCE GUIDE

QUICK REFERENCE GUIDE cm H O 2 cm H O 2 cm HO 2 PSI cm H O 2 ON OFF UPPER LIMIT LOWER LIMIT UPPER LIMIT LOWER LIMIT LIFE PULSE HIGH-FREQUENCY VENTILATOR QUICK REFERENCE GUIDE 01388-08.11 MONITOR PIP JET VALVE ALARMS READY SILENCE

More information

Mechanical Ventilation. Which of the following is true regarding ventilation? Basics of Ventilation

Mechanical Ventilation. Which of the following is true regarding ventilation? Basics of Ventilation Mechanical Ventilation Jeffrey L. Wilt, MD, FACP, FCCP Associate Professor of Medicine Michigan State University Associate Program Director MSU-Grand Rapids Internal Medicine Residency Which of the following

More information

6 th Accredited Advanced Mechanical Ventilation Course for Anesthesiologists. Course Test Results for the accreditation of the acquired knowledge

6 th Accredited Advanced Mechanical Ventilation Course for Anesthesiologists. Course Test Results for the accreditation of the acquired knowledge 6 th Accredited Advanced Mechanical Ventilation Course for Anesthesiologists Course Test Results for the accreditation of the acquired knowledge Q. Concerning the mechanics of the newborn s respiratory

More information

NAVA Neurally Adjusted Ventilatory Assist In Neonates

NAVA Neurally Adjusted Ventilatory Assist In Neonates NAVA Neurally Adjusted Ventilatory Assist In Neonates Howard Stein, M.D. Director Neonatology Toledo Children s Hospital Toledo, Ohio Disclaimers Dr Stein: Is on the speaker s bureau for Maquet Is discussing

More information

Ventilator Training Module

Ventilator Training Module Ventilator Training Module LTV (Lap Top Ventilator) Teaching Script LTV User guides: http://www.carefusion.com/documents/guides/user-guides/rc_ltv-1000_ug_en.pdf http://www.carefusion.com/documents/guides/user-guides/rc_ltv-1100_ug_en.pdf

More information

Newer forms of conventional ventilation for preterm newborns

Newer forms of conventional ventilation for preterm newborns Acta Pædiatrica ISSN 0803 5253 REVIEW ARTICLE Newer forms of conventional ventilation for preterm newborns Sunil K Sinha (Sunil.sinha@stees.nhs.uk) 1, Steven M Donn 2 1.Professor of Paediatrics and Neonatal

More information

Manual: Biphasic Positive Airway Pressure (BiPAP) Ventilation

Manual: Biphasic Positive Airway Pressure (BiPAP) Ventilation RCH@Home Manual: Biphasic Positive Airway Pressure (BiPAP) Ventilation 1. Commonly used terms... 2 1.1 Inspiration... 2 1.2 Expiration... 2 1.3 Breath rate (bpm)... 2 1.4 Ventilation... 2 1.5 Biphasic

More information

Breathing during mask ventilation of preterm infants at birth

Breathing during mask ventilation of preterm infants at birth 6 Breathing during mask ventilation of preterm infants at birth Corinne J.M. van der Pot Kim Schilleman Stuart B. Hooper Colin J. Morley Frans J. Walther Arjan B. te Pas Submitted Chapter 6 Abstract Objective

More information

evolution 3e Ventilators

evolution 3e Ventilators evolution 3e Ventilators A new paradigm in blower-based ventilators, delivering ICU ventilator care anywhere, anytime. Comprehensive graphics and trending High performance PSOL and active exhalation Servo

More information

PART ONE CHAPTER ONE PRIMARY CONSIDERATIONS RELATING TO THE PHYSIOLOGICAL AND PHYSICAL ASPECTS OF THE MECHANICAL VENTILATION OF THE LUNG

PART ONE CHAPTER ONE PRIMARY CONSIDERATIONS RELATING TO THE PHYSIOLOGICAL AND PHYSICAL ASPECTS OF THE MECHANICAL VENTILATION OF THE LUNG PART ONE CHAPTER ONE PRIMARY CONSIDERATIONS RELATING TO THE PHYSIOLOGICAL AND PHYSICAL ASPECTS OF THE MECHANICAL VENTILATION OF THE LUNG POSSIBLE ORIGIN OF THE MECHANICAL VENTILATION OF THE LUNG- The first

More information

Disclosures. The Pediatric Challenge. Topics for Discussion. Traditional Anesthesia Machine. Tidal Volume = mls/kg 2/13/14

Disclosures. The Pediatric Challenge. Topics for Discussion. Traditional Anesthesia Machine. Tidal Volume = mls/kg 2/13/14 2/13/14 Disclosures Optimal Ventilation of the Pediatric Patient in the OR Consulting Draeger Medical Jeffrey M. Feldman, MD, MSE Division Chief, General Anesthesia Dept. of Anesthesiology and Critical

More information

Modelling and Simulation of Pressure Controlled Mechanical Ventilation System

Modelling and Simulation of Pressure Controlled Mechanical Ventilation System J. Biomedical Science and Engineering, 2015, 8, 707-716 Published Online October 2015 in SciRes. http://www.scirp.org/journal/jbise http://dx.doi.org/10.4236/jbise.2015.810068 Modelling and Simulation

More information

Oxylog 3000 plus Emergency & Transport Ventilation

Oxylog 3000 plus Emergency & Transport Ventilation Oxylog 3000 plus Emergency & Transport Ventilation Offering high ventilation performance with features such as AutoFlow, integrated capnography and non-invasive Ventilation, the compact and robust Oxylog

More information

Factors which may improve the respiratory effort at birth of preterm infants.

Factors which may improve the respiratory effort at birth of preterm infants. Factors which may improve the respiratory effort at birth of preterm infants. The use of antenatal steroids Skilled personnel at deliveries Each delivery should have at least 1 person whose primary role

More information

Primus Infinity Empowered

Primus Infinity Empowered Primus Infinity Empowered Welcome to the next level Emergency Care Perioperative Care Critical Care Perinatal Care Home Care The next level of reliable performance Primus Infinity Empowered Infinity Acute

More information

How Ventilators Work. Chapter 3

How Ventilators Work. Chapter 3 How Ventilators Work Chapter 3 To care for a ventilator patient, you need to know: The various functions of the ventilator used How the ventilator interacts with the patient How changes in lung condition

More information

Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia and Critical Care Service Puerta de Hierro University Hospital Associate Professor.

Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia and Critical Care Service Puerta de Hierro University Hospital Associate Professor. Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia and Critical Care Service Puerta de Hierro University Hospital Associate Professor. Medical School. UAM CV and Conflict of interest Chairman

More information

Respiratory Physiology Gaseous Exchange

Respiratory Physiology Gaseous Exchange Respiratory Physiology Gaseous Exchange Session Objectives. What you will cover Basic anatomy of the lung including airways Breathing movements Lung volumes and capacities Compliance and Resistance in

More information

VENTILATION SERVO-s EASY AND RELIABLE PATIENT CARE

VENTILATION SERVO-s EASY AND RELIABLE PATIENT CARE VENTILATION SERVO-s EASY AND RELIABLE PATIENT CARE Critical Care SERVO-s 3 SERVO-s SIMPLY MAKES SENSE MAQUET THE GOLD STANDARD Leading the way: MAQUET is a premier international provider of medical products

More information

ASV. Adaptive Support Ventilation

ASV. Adaptive Support Ventilation ASV Adaptive Support Ventilation Intelligent Ventilation since 1983 We live for ventilation technology We live for ventilation technology that helps caregivers improve the lives of their critically ill

More information

INTENSIVE CARE VENTILATORS

INTENSIVE CARE VENTILATORS INTENSIVE CARE VENTILATORS iternis ADV INTENSIVE CARE VENTILATION FOR ALL PATIENT CATEGORIES Design Features HEYER iternis ADV s 12-inch touch-screen display combines comprehensive, easy-to-follow user

More information

Fabius Tiro TM. Designed for your environment. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care

Fabius Tiro TM. Designed for your environment. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Fabius Tiro TM Designed for your environment Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Traditional hospital ORs have their needs... With more surgical procedures being performed

More information

Wales Neonatal Network Guideline

Wales Neonatal Network Guideline Neonatal Ventilation: Ventilation Modes Please refer to the longer version of this guideline (available on the network website) for further detailed information. Commonly used ventilation modalities: Continuous

More information

fabian HFO Our 4-in-1 device

fabian HFO Our 4-in-1 device fabian HFO Our 4-in-1 device Ventilation Beyond Limits When It Comes to Life, There Is No Compromise Distributing worldwide ACUTRONIC is a privately held company that develops, manufactures, and distributes

More information

SLE6000 Infant Ventilator. Multi-Mode, Touch-Screen Infant Ventilator SLE6000

SLE6000 Infant Ventilator. Multi-Mode, Touch-Screen Infant Ventilator SLE6000 SLE6000 Infant Ventilator Multi-Mode, Touch-Screen Infant Ventilator SLE6000 Ventilate with Confidence The care of infants and in particular neonates is hugely challenging. Their unique physiological

More information

PROBLEM SET 9. SOLUTIONS April 23, 2004

PROBLEM SET 9. SOLUTIONS April 23, 2004 Harvard-MIT Division of Health Sciences and Technology HST.542J: Quantitative Physiology: Organ Transport Systems Instructors: Roger Mark and Jose Venegas MASSACHUSETTS INSTITUTE OF TECHNOLOGY Departments

More information

Life Pulse High Frequency Ventilator In-Service Manual

Life Pulse High Frequency Ventilator In-Service Manual Life Pulse High Frequency Ventilator In-Service Manual 01513-07.12 436 Lawndale Drive Salt Lake City, UT 84115 Phone: 801-467-0800 Hotline: 800-800-4358 Fax: 801-467-0867 Website: www.bunl.com 01801-07.12

More information

A bench study comparison of volume delivery in the presence of leak

A bench study comparison of volume delivery in the presence of leak A bench study comparison of volume delivery in the presence of leak Study objective To compare the volume delivery of the Trilogy1 ventilator to the volume delivery of the LTV 1 as a representative of

More information

Human gas exchange. Question Paper. Save My Exams! The Home of Revision. Cambridge International Examinations. 56 minutes. Time Allowed: Score: /46

Human gas exchange. Question Paper. Save My Exams! The Home of Revision. Cambridge International Examinations. 56 minutes. Time Allowed: Score: /46 Human gas exchange Question Paper Level Subject Exam oard Topic Sub Topic ooklet O Level iology ambridge International Examinations Respiration Human gas exchange Question Paper Time llowed: 56 minutes

More information

Lung Volumes and Capacities

Lung Volumes and Capacities Lung Volumes and Capacities Normally the volume of air entering the lungs during a single inspiration is approximately equal to the volume leaving on the subsequent expiration and is called the tidal volume.

More information

VENTILATORS PURPOSE OBJECTIVES

VENTILATORS PURPOSE OBJECTIVES VENTILATORS PURPOSE To familiarize and acquaint the transfer Paramedic with the skills and knowledge necessary to adequately maintain a ventilator in the interfacility transfer environment. COGNITIVE OBJECTIVES

More information

Ventilators AVEA. frequency ventilator. Neonate, pediatric, adult. pediatric (350 g-25 kg) Patient Setting

Ventilators AVEA. frequency ventilator. Neonate, pediatric, adult. pediatric (350 g-25 kg) Patient Setting ECHnologyGuide Ventilators Product name Patient range Bunnell Inc Life Pulse high frequency ventilator Premature to small pediatric (350 g-25 kg) Cardinal Health AVEA Neonate, pediatric, adult Patient

More information

Respiratory Pulmonary Ventilation

Respiratory Pulmonary Ventilation Respiratory Pulmonary Ventilation Pulmonary Ventilation Pulmonary ventilation is the act of breathing and the first step in the respiratory process. Pulmonary ventilation brings in air with a new supply

More information

Astral in AirView: Improving patient care through connectivity. ResMed.com

Astral in AirView: Improving patient care through connectivity. ResMed.com Astral in AirView: Improving patient care through connectivity ResMed.com This guide will assist you with: Setting up the ResMed Connectivity Module for Astral 2 Troubleshooting the ResMed Connectivity

More information

LAB 7 HUMAN RESPIRATORY LAB. Complete the charts on pgs. 67 and 68 and read directions for using BIOPAC

LAB 7 HUMAN RESPIRATORY LAB. Complete the charts on pgs. 67 and 68 and read directions for using BIOPAC 66 LAB 7 HUMAN RESPIRATORY LAB Assignments: Due before lab: Quiz: Three Respiratory Interactive Physiology Animations pages 69 73. Complete the charts on pgs. 67 and 68 and read directions for using BIOPAC

More information

respiratory care aerosol therapy

respiratory care aerosol therapy ISSUE 2.0 respiratory care aerosol therapy & manual silicone resuscitators resuscitation sets disposable resuscitators cpr pocket resuscitator silicone masks guedel airways AEROSOL, OXYGEN & HI-OXYGEN

More information

Recommendations on Checking Anaesthesia Delivery Systems

Recommendations on Checking Anaesthesia Delivery Systems Page 1 of 11 Recommendations on Checking Anaesthesia Delivery Version Effective Date 1 Oct 1992 (reviewed Feb 07, Feb 02) 2 2004 3 Nov 2011 4 Dec 2016 Document No. HKCA T1 v4 Prepared by College Guidelines

More information

Underlying Principles of Mechanical Ventilation: An Evidence-Based Approach

Underlying Principles of Mechanical Ventilation: An Evidence-Based Approach Underlying Principles of Mechanical Ventilation: An Evidence-Based Approach Ira M. Cheifetz, MD, FCCM, FAARC Professor of Pediatrics and Anesthesiology Chief Medical Officer, Children s Services Associate

More information

Capnography A Monitoring Tool with Usual and Unusual Applications

Capnography A Monitoring Tool with Usual and Unusual Applications Capnography A Monitoring Tool with Usual and Unusual Applications Jon Palmer, VMD, DACVIM New Bolton Center All animations from: Caprnography.com By BS Kodali, MD Sponsored by Capnography 1943 Luft developed

More information

Driving Pressure. What is it, and why should you care?

Driving Pressure. What is it, and why should you care? Driving Pressure What is it, and why should you care? Jonathan Pak MD March 2, 2017 Lancet 1967; 290: 319-323 Traditional Ventilation in ARDS Tidal Volume (V T ) = 10-15 ml/kg PBW PEEP = 5-12 cm H 2 O

More information

Respiratory Care. and Aerosol Therapy

Respiratory Care. and Aerosol Therapy Respiratory Care and Aerosol Therapy MANUAL SILICONE RESUSCITATORS RESUSCITATION SETS DISPOSABLE RESUSCITATORS CPR POCKET RESUSCITATOR SILICONE MASKS GUEDEL AIRWAYS AEROSOL MASKS OXYGEN & HI-OXYGEN OXYGEN

More information

Operation of Oxylog 3000 ventilator

Operation of Oxylog 3000 ventilator Operation of Oxylog 3000 ventilator Overview Suitable for patients from approximately 7Kg body weight upwards (smallest tidal volume 50mls). Entirely power dependant- will not ventilate if no available

More information

Boards and Beyond: Pulmonary

Boards and Beyond: Pulmonary Boards and Beyond: Pulmonary A Companion Book to the Boards and Beyond Website Jason Ryan, MD, MPH i ii Table of Contents Pulmonary Anatomy 1 Treatment of COPD/Asthma 45 Pulmonary Physiology 4 Pneumonia

More information

Intelligent Ventilation solution from ICU to MRI

Intelligent Ventilation solution from ICU to MRI Intelligent Ventilation solution from ICU to MRI www.hamilton-medical.com/mr1 Supporting you in saving lives! HAMILTON-MR1 ventilators feature a compact, powerful design that increase the availability

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Talmor D, Sarge T, Malhotra A, et al. Mechanical ventilation

More information

PART TWO CHAPTER 4 THE RAMIFICATIONS OF INTRAPULMONARY PERCUSSIVE VENTILATION (IPV ) and associated MECHANICAL INTRATHORACIC VESICULAR PERISTALSIS

PART TWO CHAPTER 4 THE RAMIFICATIONS OF INTRAPULMONARY PERCUSSIVE VENTILATION (IPV ) and associated MECHANICAL INTRATHORACIC VESICULAR PERISTALSIS PART TWO CHAPTER 4 THE RAMIFICATIONS OF INTRAPULMONARY PERCUSSIVE VENTILATION (IPV ) and associated MECHANICAL INTRATHORACIC VESICULAR PERISTALSIS A DISCUSSION In 1979 F. M. Bird conceived the technology

More information

Invasive Ventilation: State of the Art

Invasive Ventilation: State of the Art ARDSnet NEJM 2000;342:1301 9-30-17 Cox Invasive Ventilation: State of the Art Bob Kacmarek PhD, RRT Harvard Medical School Massachusetts General Hospital Boston, Massachusetts A V T of 6 ml/kg PBW results

More information

Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia, Critical Care and Pain Service Puerta de Hierro University Hospital Associate

Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia, Critical Care and Pain Service Puerta de Hierro University Hospital Associate Javier García Fernández. MD. Ph.D. MBA. Chairman of Anaesthesia, Critical Care and Pain Service Puerta de Hierro University Hospital Associate Professor. Medical School. UAM Non-anaesthesiated healthy

More information

Volume-Targeted Ventilation and Arterial Carbon Dioxide in Neonates

Volume-Targeted Ventilation and Arterial Carbon Dioxide in Neonates Volume-Targeted Ventilation and Arterial Carbon Dioxide in Neonates Catherine Dawson 1 and Mark William Davies 1,2 1 Grantley Stable Neonatal Unit, Royal Women s Hospital and 2 Department of Paediatrics

More information

Question 1: Define vital capacity. What is its significance? Vital capacity is the maximum volume of air that can be exhaled after a maximum inspiration. It is about 3.5 4.5 litres in the human body. It

More information

Introduction. Respiration. Chapter 10. Objectives. Objectives. The Respiratory System

Introduction. Respiration. Chapter 10. Objectives. Objectives. The Respiratory System Introduction Respiration Chapter 10 The Respiratory System Provides a means of gas exchange between the environment and the body Plays a role in the regulation of acidbase balance during exercise Objectives

More information

Volumetric Gas Measurements Measurement Site Considerations

Volumetric Gas Measurements Measurement Site Considerations W H I T E P A P E R Volumetric Gas Measurements Measurement Site Considerations ABSTRACT For the measurement of gas exchange (such as carbon dioxide elimination), the choice of the gas and flow measurement

More information

Ventilator Management for the Practicing Emergency Physician

Ventilator Management for the Practicing Emergency Physician Ventilator Management for the Practicing Emergency Physician Dave Caro, MD Program Director Emergency Medicine University of Florida College of Medicine-Jacksonville Vent Management Why do I care? Who

More information

Neonatal Ventilators. Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000

Neonatal Ventilators. Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000 Neonatal Ventilators Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000 SLE5000: Designed for Neonates Neonatal ventilation poses real challenges to neonatologists and caregivers.

More information

TOPO. operating Manual

TOPO. operating Manual TOPO Dual Mode Ventilator operating Manual Rev. B1a September, 2009 Table of Contents General Information... 3 Contact Information... 3 Disclaimer... 3 Warranty... 3 Repairs... 3 Customer Satisfaction...

More information

DATA SHEET. VENTILATION SERVO-i INFANT HIGHLIGHTS

DATA SHEET. VENTILATION SERVO-i INFANT HIGHLIGHTS DATA SHEET VENTILATION HIGHLIGHTS For neonatal to pediatric patients Intuitive user interface Designed for cost-efficiency Flexible placement Modular - interchangeable plug-in units Enables Heliox delivery

More information

HAMILTON-MR1. Technical specifications HAMILTON-MR1

HAMILTON-MR1. Technical specifications HAMILTON-MR1 HAMILTONMR1 HAMILTONMR1 Technical specifications The HAMILTONMR1 guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with

More information

State-of-the-art anesthesia technology

State-of-the-art anesthesia technology State-of-the-art anesthesia technology anesthesia system Get closer to the MRI scanner Superb certified performance in close proximity to strong magnetic fields. Our innovative machine provides benefits

More information

RESPIRATORY MUSCLES IN HEALTH AND EMPHYSEMA *

RESPIRATORY MUSCLES IN HEALTH AND EMPHYSEMA * THE OXYGEN CONSUMPTION AND EFFICIENCY OF THE RESPIRATORY MUSCLES IN HEALTH AND EMPHYSEMA * BY REUBEN M. CHERNIACK t (From The Winnipeg General Hospital and the Departments of Medicine and Physiology and

More information

New Anesthesia Delivery Systems What Do I Need to Know About My New Machine?

New Anesthesia Delivery Systems What Do I Need to Know About My New Machine? New Anesthesia Delivery Systems What Do I Need to Know About My New Machine? James H. Philip, MEE, MD, CCE Anesthesiologist and Director Bioengineering Department of Anesthesiology, Pain, and Peri-operative

More information

Operating & troubleshooting a self inflating bag. Victorian Newborn Resuscitation Project Updated February 2012

Operating & troubleshooting a self inflating bag. Victorian Newborn Resuscitation Project Updated February 2012 Operating & troubleshooting a self inflating bag Six key steps to success Step 1 Choose the correct size self inflating bag for newborn resuscitation: a 240 ml bag Step 2 Choose the correct sized mask

More information

Mechanical Ventilation Guided by Esophageal Pressure in Acute Lung Injury *

Mechanical Ventilation Guided by Esophageal Pressure in Acute Lung Injury * A teaching hospital of Harvard Medical School Mechanical Ventilation Guided by Esophageal Pressure in Acute Lung Injury * Ray Ritz BA RRT FAARC Beth Israel Deaconess Medical Center Boston MA * n engl j

More information

Anesthesia Delivery Systems What Do I Need to Know About My Machine? A Workshop James H. Philip, MEE, MD, CCE

Anesthesia Delivery Systems What Do I Need to Know About My Machine? A Workshop James H. Philip, MEE, MD, CCE Anesthesia Delivery Systems What Do I Need to Know About My Machine? A Workshop James H. Philip, MEE, MD, CCE Anesthesiologist and Director Bioengineering Department of Anesthesiology, Pain, and Peri-operative

More information

Physiology Unit 4 RESPIRATORY PHYSIOLOGY

Physiology Unit 4 RESPIRATORY PHYSIOLOGY Physiology Unit 4 RESPIRATORY PHYSIOLOGY In Physiology Today Respiration External respiration ventilation gas exchange Internal respiration cellular respiration gas exchange Respiratory Cycle Inspiration

More information

Compressive force applied to a manikin s head during mask ventilation

Compressive force applied to a manikin s head during mask ventilation ADC-FNN Online First, published on December 5, 2011 as 10.1136/archdischild-2011-300336 Original article Compressive force applied to a manikin s head during mask ventilation Jeroen J van Vonderen, 1 Ted

More information

Infant Ventilators. Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000

Infant Ventilators. Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000 Infant Ventilators Touch-screen Neonatal Ventilator with High Frequency Oscillation SLE5000 SLE5000: Designed for Infants Sophisticated and Powerful To keep up with the latest in ventilation the SLE5000

More information

Fabius plus. The plus that makes all the difference. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care

Fabius plus. The plus that makes all the difference. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Fabius plus The plus that makes all the difference Emergency Care Perioperative Care Critical Care Perinatal Care Home Care More features, more options add up to more advantages Economical To meet today

More information

Fabius plus. The plus that makes all the difference. Because you care. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care

Fabius plus. The plus that makes all the difference. Because you care. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Fabius plus The plus that makes all the difference Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Because you care More features, more options add up to more advantages Economical

More information

Lung Volumes and Capacities. To review first

Lung Volumes and Capacities. To review first Lung Volumes and Capacities To review first Age-old story: Age-related respiratory changes Structural changes Nose enlargement (from continued cartilage growth) General atrophy of the tonsils Tracheal

More information

Draeger Fabius GS Pre-Use Check

Draeger Fabius GS Pre-Use Check Draeger Fabius GS Pre-Use Check James H Philip MEE, MD, CCE 2011 James H Philip All rights reserved Remember to enter Machine # Fabius GS front view Fabius GS pre-use checkout procedure Fabius GS pre-use

More information

Fabius Tiro TM. Designed for your environment. Because you care. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care

Fabius Tiro TM. Designed for your environment. Because you care. Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Fabius Tiro TM Designed for your environment Emergency Care Perioperative Care Critical Care Perinatal Care Home Care Because you care Traditional hospital ORs have their needs... With more surgical procedures

More information

Measuring Lung Capacity

Measuring Lung Capacity Measuring Lung Capacity 1 Name Measuring Lung Capacity Background Information: We need a constant supply of oxygen in order to stay alive. We use oxygen to break down food to release energy and produce

More information

Instructions/Procedure for Use of the Speaking Valve

Instructions/Procedure for Use of the Speaking Valve Instructions/Procedure for Use of the Speaking Valve Notes on the use of the speaking valve for ventilator-dependent and non-ventilator dependent patients The speaking valve is a one-way valve that allows

More information