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Ventilator Graphics PDF

This document discusses the information that can be learned from neonatal ventilator graphics and waveforms. It provides examples of pressure, flow, and volume waveforms as well as pressure-volume and flow-volume loops. Key features of the waveforms and loops are described, such as peaks and troughs that indicate measures like compliance and resistance. While graphics provide valuable information to optimize settings and detect lung issues, their direct impact on outcomes requires further clarification. Overall, ventilator graphics allow clinicians to visualize ventilation and better understand lung mechanics.

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Rina Anggraini
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445 views

Ventilator Graphics PDF

This document discusses the information that can be learned from neonatal ventilator graphics and waveforms. It provides examples of pressure, flow, and volume waveforms as well as pressure-volume and flow-volume loops. Key features of the waveforms and loops are described, such as peaks and troughs that indicate measures like compliance and resistance. While graphics provide valuable information to optimize settings and detect lung issues, their direct impact on outcomes requires further clarification. Overall, ventilator graphics allow clinicians to visualize ventilation and better understand lung mechanics.

Uploaded by

Rina Anggraini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Ventilator graphics and waveforms

What can we learn?

Anton van Kaam, MD, PhD


Emma Children’s Hospital
Academic Medical Center
Amsterdam, The Netherlands
Neonatal ventilators
The start: just settings
Neonatal ventilators
And then: numbers
Neonatal ventilators
And then: some basic graphics
Neonatal ventilators
And now: lots of graphics!
Neonatal ventilators
And now: lots of graphics, but….
Ventilator graphics
…...
• Ventilator waveforms (vs time):
– Pressure waveform
– Flow waveform
– Volume waveform
• Ventilator loops
– Pressure-volume loop
– Flow-volume loop
Ventilator graphics
Pressure waveform

PIP PEEP Rise Plateau

Ti Te

Red = inspiration
Blue = expiration
Ventilator graphics
Pressure waveform: MAwP
Pressure (cm H2O)

1
20
4
1. Increase PIP
2. Increase PEEP
3 3. Increase I-time
10 4. Increase flow

Ti Te Ti
Time (sec)
Ventilator graphics
Pressure waveform
Ventilator graphics
Flow waveform
Ventilator graphics
Flow waveform
Peak Insp flow

Peak Exp. flow


VTin
VTex
Ventilator graphics
Reading flow patterns

Plateau pressure

Decelerating flow

Time cycled
Ventilator graphics
Reading flow patterns

Peak pressure

Block wave flow

Volume cycled
Ventilator graphics
Flow waveform

No plateau
PIP

Insp. flow
not zero

Increase flow
Increase Ti
Ventilator graphics
Flow waveform
Ventilator graphics
Flow waveform

Insp. flow
not zero

4 VTex not zero


Ventilator graphics
Flow waveform: autoPEEP

Exp.. flow
not zero

4
Ventilator graphics
Flow waveform: airway resistance

Resistance low

Resistance high
Ventilator graphics
Flow waveform: Turbulence

“Noisy” appearance flow waveform

Becker MA, Donn SM. Clin Perinatol 2007


Ventilator graphics
Pressure-volume loop
Volume
Expiration PIP

Inspiration

Pressure PEEP
Becker MA, Donn SM. Clin Perinatol 2007
Ventilator graphics
Pressure-volume loop
Volume Compliance = △V/△P

Good compliance will


have a compliance axis
>45° if axes are
properly scaled.

Compliance
line

Pressure
Becker MA, Donn SM. Clin Perinatol 2007
Ventilator graphics
Pressure-volume loop

Low compliance High compliance


Ventilator graphics
Pressure-volume loop

High opening pressure Low opening pressure


(increase PEEP)
Sinha SK, Nicks JJ, Donn SM. ADC-FN 1996
Ventilator graphics
Pressure-volume loop
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


Ventilator graphics
Flow-volume loop
Peak inspiratory flow
Flow

Volume

Peak expiratory flow


Becker MA, Donn SM. Clin Perinatol 2007
Ventilator graphics
Flow-volume loop

High resistance Low resistance


Ventilator graphics
Conclusions
• Ventilatory graphics are increasing available
• They provide valuable information:
– to optimize settings
– detect lung pathology
• Measure flow at the Y-piece!
• Use proper scaling!
• Effect on outcome not clear
Thank you!

[email protected]

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