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11/19/2008   ©2008 Alraiyes   1
Quiz?


11/19/2008    ©2008 Alraiyes   2
Ventilation “CO2 wash out”




     To wash out CO2 in a mechanical ventilated patient I will
     adjust the:

     A. FiO2 and RR
     B. Vt, PEEP and RR
     C. RR, PEEP and FiO2
     D. Vt and RR




11/19/2008                   ©2008 Alraiyes                      3
Oxygenation




     To increase SpO2 in a mechanical ventilated patient I will
     adjust the:

     A. FiO2 and RR
     B. PEEP and FiO2
     C. RR, PEEP and FiO2
     D. Vt and RR




11/19/2008                   ©2008 Alraiyes                       4
Plateau Pressure?




                 A

                                B

             P
                 C

                                      D


                            V

11/19/2008           ©2008 Alraiyes       5
Compliance?




     Transthoracic Compliance =

     A. C = Vt x RR / PEEP
     B. C = Pplt / VT
     C. C = Vt / Pplt - PEEP
     D. C = Vt / Pk - Pplt




11/19/2008                      ©2008 Alraiyes   6
FiO2




FiO2 at the mount of Everest =

A. 25%
B. 15%
C. 21%
D. 12%


 11/19/2008                 ©2008 Alraiyes   7
What are the functions of any type of
                   mechanical ventilation?




11/19/2008                   ©2008 Alraiyes          8
Mechanical ventilation




         Oxygenation                      Ventilation



             •FIO2                           •RR
             •PEEP                           • Vt
11/19/2008               ©2008 Alraiyes                 9
P
               •Shunting and dead space.
               •Decrease CO and Renal output.
               •Nosocomial pneumonia.
               •Increased ICP.



                V




11/19/2008   ©2008 Alraiyes                     10
R=P/Q




                   Air way
                              C=V/P




11/19/2008   ©2008 Alraiyes           11
P




                  V


11/19/2008       ©2008 Alraiyes   12
VILI         •Barotrauma.
                          •Oxygen toxicity .
                          •Volutrauma.
                          •Atelectrauma.
                          •Biotrauma.
                          •Translocation of the cells.
P




                    V

11/19/2008              ©2008 Alraiyes                   13
P




                  V

11/19/2008       ©2008 Alraiyes   14
Peak




                         Plateau




             Air way



11/19/2008             ©2008 Alraiyes   15
P




11/19/2008       ©2008 Alraiyes   16
Plateau




        P




             V

11/19/2008   ©2008 Alraiyes   17
WAVES




11/19/2008   ©2008 Alraiyes   18
Pressure wave




Ppeak   20



21
        0
      cmH2O




11/19/2008        ©2008 Alraiyes   19
Flow wave



   F

 60
L/Min




 11/19/2008     ©2008 Alraiyes   20
Volume wave




   Vt


451
        mL




11/19/2008      ©2008 Alraiyes   21
Modes of ventilation




11/19/2008           ©2008 Alraiyes   22
CPAP




11/19/2008   ©2008 Alraiyes   23
PS




11/19/2008   ©2008 Alraiyes   24
CMV




11/19/2008   ©2008 Alraiyes   25
CMV




11/19/2008   ©2008 Alraiyes   26
SIMV




11/19/2008   ©2008 Alraiyes   27
SIMV + PS




11/19/2008     ©2008 Alraiyes   28
Thank You

11/19/2008      ©2008 Alraiyes   29

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Mechanical Ventilation

  • 1. 11/19/2008 ©2008 Alraiyes 1
  • 2. Quiz? 11/19/2008 ©2008 Alraiyes 2
  • 3. Ventilation “CO2 wash out” To wash out CO2 in a mechanical ventilated patient I will adjust the: A. FiO2 and RR B. Vt, PEEP and RR C. RR, PEEP and FiO2 D. Vt and RR 11/19/2008 ©2008 Alraiyes 3
  • 4. Oxygenation To increase SpO2 in a mechanical ventilated patient I will adjust the: A. FiO2 and RR B. PEEP and FiO2 C. RR, PEEP and FiO2 D. Vt and RR 11/19/2008 ©2008 Alraiyes 4
  • 5. Plateau Pressure? A B P C D V 11/19/2008 ©2008 Alraiyes 5
  • 6. Compliance? Transthoracic Compliance = A. C = Vt x RR / PEEP B. C = Pplt / VT C. C = Vt / Pplt - PEEP D. C = Vt / Pk - Pplt 11/19/2008 ©2008 Alraiyes 6
  • 7. FiO2 FiO2 at the mount of Everest = A. 25% B. 15% C. 21% D. 12% 11/19/2008 ©2008 Alraiyes 7
  • 8. What are the functions of any type of mechanical ventilation? 11/19/2008 ©2008 Alraiyes 8
  • 9. Mechanical ventilation Oxygenation Ventilation •FIO2 •RR •PEEP • Vt 11/19/2008 ©2008 Alraiyes 9
  • 10. P •Shunting and dead space. •Decrease CO and Renal output. •Nosocomial pneumonia. •Increased ICP. V 11/19/2008 ©2008 Alraiyes 10
  • 11. R=P/Q Air way C=V/P 11/19/2008 ©2008 Alraiyes 11
  • 12. P V 11/19/2008 ©2008 Alraiyes 12
  • 13. VILI •Barotrauma. •Oxygen toxicity . •Volutrauma. •Atelectrauma. •Biotrauma. •Translocation of the cells. P V 11/19/2008 ©2008 Alraiyes 13
  • 14. P V 11/19/2008 ©2008 Alraiyes 14
  • 15. Peak Plateau Air way 11/19/2008 ©2008 Alraiyes 15
  • 16. P 11/19/2008 ©2008 Alraiyes 16
  • 17. Plateau P V 11/19/2008 ©2008 Alraiyes 17
  • 18. WAVES 11/19/2008 ©2008 Alraiyes 18
  • 19. Pressure wave Ppeak 20 21 0 cmH2O 11/19/2008 ©2008 Alraiyes 19
  • 20. Flow wave F 60 L/Min 11/19/2008 ©2008 Alraiyes 20
  • 21. Volume wave Vt 451 mL 11/19/2008 ©2008 Alraiyes 21
  • 22. Modes of ventilation 11/19/2008 ©2008 Alraiyes 22
  • 23. CPAP 11/19/2008 ©2008 Alraiyes 23
  • 24. PS 11/19/2008 ©2008 Alraiyes 24
  • 25. CMV 11/19/2008 ©2008 Alraiyes 25
  • 26. CMV 11/19/2008 ©2008 Alraiyes 26
  • 27. SIMV 11/19/2008 ©2008 Alraiyes 27
  • 28. SIMV + PS 11/19/2008 ©2008 Alraiyes 28
  • 29. Thank You 11/19/2008 ©2008 Alraiyes 29