ventilator graphics that shows scalar and loops

graphic of ventilator, scalar, loops

1. Ventilator
Graphics
FAY ALBUAINAIN

2. Objectives:
•Introduction
•Why We Need To Know About The Ventilator Graphics ?
•Types Of Waveforms
•Types Of Breath
•Normal And Abnormal Waveforms

3. Introduction:
Monitoringandanalysisofgraphicdisplayofcurvesand
loopsduringmechanicalventilationhasbecomecriticalto
determinehowpatientisbeingventilatedtoassess
problemsoccurringduringventilation.

4. Mode
function
Auto PEEP
Synchrony
Trigger
WOB
Over distension
PEEP
Ti
Leak
Flow
cycle
Time
rise
Active
exhalation
Why we need to know about the ventilator graphics ?

5. Types Of Waveforms:
Scalars
P-T
F-T
V-T
Loops
F-V
P-V

6. Scalars

7. Types Of Waveforms:
VC-CMV
SIMV+VC
PC-CMV VAP
APRV
SIMV+PC PSV
•Constant
•Sinusoidal
•Ascending
•Descending
•Exponential
•Ascending
•Sinusoidal
•Constant
•Exponential
•Constant
•Sinusoidal
•Ascending
•
Descending
•
Exponential
•Ascending
•Sinusoidal
•Constant
•Exponential
VC PC
?

8. Type Of Breath:
Mandatory Assisted Spontaneous
Inspiration
Expiration

9. P-T
PIP
TransairwayPressure (P
TA)
P
plateau
PEEP
Begin Inspiration
Begin Expiration
B
C
A= airway Raw
B= Alveolar distending
pressure
ABC = MAP

10. Respiratory Mechanics:
↑ RAW ↓ COMPLIANCE
A
B
A
B

11. Time rise:
Minimal Pressure Overshoot
P
What is the benefit of the
time rise ?

12. Inspiration
Expiration
Time (sec)
TI T
E
F-T
Beginning of inspiration
exhalation valve closes
Peak inspiratory
flow rate PIFR
End inspiration and
beginning of expiration
exhalation valve opens
Peak expiratory
flow rate PEFR

13. Inspiration
Expiration
Inspiratory Tidal Volume
TI
V-T
Tidal
volume

14. Abnormalities

15. VC302928272625242322212019181716151413121110987654321
Increase Raw

16. PC302928272625242322212019181716151413121110987654321
Decrease
Compliance

17. VC302928272625242322212019181716151413121110987654321
Decrease
compliance

18. 302928272625242322212019181716151413121110987654321
Leak

19. 302928272625242322212019181716151413121110987654321
Inadequate Flow
“ Flow Starvation”

20. 302928272625242322212019181716151413121110987654321
Active
Exhalation

21. Loops

22. P-V LOOP
PIP
V
T
What does
that point
indicates ?

23. Type Of Breath:
Controlled Assisted Spontaneous
I
E
E
E
I
IPEEP

24. Types Of Waveform:
PC Ps VC

25. WOB
The more verticalthe loop
lays, the higher the lung
compliance, the more
horizontal it lays, the lower
the lung compliance. Thus
slopeof the line equals
compliance.
The fatterthe loop, the
higher the airway
resistance…you can tell if
it’s I or E resistance by
looking at whether the
right or left side bulges out
more

26. F-V LOOP
PEFR
FRC
Inspiration
Expiration
V
T
F
T
PIFR

27. F-V LOOP
Inspiration
Expiration

28. Abnormalities

29. 302928272625242322212019181716151413121110987654321
Decrease
compliance
e.g. ARDS,
atelectasis
and CHF

30. 302928272625242322212019181716151413121110987654321
Increase
compliance

31. Leak
302928272625242322212019181716151413121110987654321

32. 302928272625242322212019181716151413121110987654321
Inadequate
Sensitivity

33. 302928272625242322212019181716151413121110987654321
Over Distension

34. 302928272625242322212019181716151413121110987654321
Increase Raw

35. 302928272625242322212019181716151413121110987654321
Leak

36. 302928272625242322212019181716151413121110987654321
Air Trapping

37. 302928272625242322212019181716151413121110987654321
Inadequate Flow
“ Flow Starvation”

38. 302928272625242322212019181716151413121110987654321
Active
Exhalation

39. 302928272625242322212019181716151413121110987654321
Increase Raw

40. 302928272625242322212019181716151413121110987654321

41. Assessment of pressure, flow and
volume waveforms is a critical tool in
the management of the mechanically
ventilated patient.

42. References:
•Pilbeam’sMechanical Ventilation, 5
th
edition.
•Curves and Loops in Mechanical Ventilation, dragger booklet.
•Handbook of Mechanical Ventilation, Kumar B Umesh, 2011.
•Maquetpocket guide,
•Ventilator Graphics and Respiratory Mechanics in the Patient With Obstructive Lung
Disease, 2005.