Dr. Ali Ragab | Critical Care Study Notes Pass Critical Care Essential ICU study notes Mechanical ventilation Dr. Ali Ragab WhatsA pp @ 01155887066 - Facebook @ ali_ragab_ali@yahoo.comDr. Ali Ragab | Critical Care Study Notes Ck Te ed Bradypnea or apnea with respiratory arrest. Tachypnea (RR > 30/minute). Minute ventilation > 10 L/min. Vital capacity < 10-15 mL/kg. ARDS. PaO, < 55 mmHg with supplemental Oz. PaCO, > 50 mmHg with arterial pH < 7.25. Exhaustion and respiratory muscle fatigue. Neuromuscular diseases. Confusion or coma. Severe shock. Severe LVF. Raised ICP. Modes of invasive mechanical ventilation Volume cycled mechanical ventilation . Delivers preset volume (V1) with each breath (specified by operator). Peak inspiratory pressures (PIP) generated by the ventilator are variable with each breath depending on airway resistance or compliance. A pop off pressure is assigned to prevent excessive peak pressures that abort the breath when that pressure limit is reached. The time that is takes to deliver the (V1) is called inspiratory time (T}) and is also controlled by the operator. WhatsA pp @ 01155887066 - Facebook @ ali_ragab_ali@yahoo.comDr. Ali Ragab | Critical Care Study Notes Ey Assist control (AC) The AC mode consists of two modes of ventilation * Assist mode > allows patient with spontaneous breathing efforts to initiate the desired machine-delivered V+. * Control mode > provides machine breaths without regard to the patient's pattern of breathing. During control and assisted breaths > Vr and inspiratory flow are exactly the same. ‘Advantages » Guaranteed Vy will be delivered. * When patients are in synchrony with ventilator > this mode allows for minimal patient effort and rest for fatigued respiratory muscles. Disadvantage | « Induced respiratory alkalosis in patients with high respiratory drive. * Patient asynchrony and respiratory muscle fatigue can occur. * I: Eratio can vary because variable RR can alter the expiratory phase. Synchronized intermittent mandatory ventilation (SIMV) SIMV consists of two types of ventilation ‘it type | * 15 type of ventilation is identical to AC mode > it provides machine delivered Vy at preset respiratory rate. [2 ype | * 24 type of ventilation allows the patient to breathe spontaneously. WhatsA pp @ 01155887066 - Facebook @ ali_ragab_ali@yahoo.com