Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

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Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University

Transcript of Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Page 1: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Ventilator Settings in

Pediatric Patients

Wanida Paoin

Thammasat Hospital,Thammasat University

Page 2: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Types of mechanical ventilation Modes of mechanical ventilation - Initial settings full ventilatory support

WeaningExtubation

Ventilator Settings in Pediatric Patients

Page 3: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Volume control ventilator

Pressure control ventilator

Infant Ventilator

Types of mechanical ventilation

Page 4: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Volume control ventilator

V

P

V

Page 5: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

V

P

V

Pressure control ventilator

Page 6: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Infant Ventilator - Time cycle, pressure

limit

V

P

V

20

Page 7: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Which Type?

Volume controlV

P

V

V

P

V

Pressure control

InfantV

P

V

20

Page 8: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Expiratory to inspiratory phase

Inspiratory phase Inspiratory to expiratory phase

Expiratory phase

Phases of mecha nical ventilation

Page 9: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

ControlAssist/Control IMV/SIMVPSVCPAP

Modes of mechanical ventilation

Page 10: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Modes of mechanical ventilation

Control

P

3 60

Page 11: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Modes of mechanical ventilation

Assist/Control

P

3 60

Page 12: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Modes of mechanical ventilation

IMV

P

3 60

Page 13: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

ITP -> venous return -> CO -> LV afterloadAware hyperinflation:Lowest PEEP, Optimal Te, Optimal PIP

WOB: flow pattern, trigger

Detrimental hemodynamic

effects

Page 14: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

TypeModeFlow Tidal volumeTI

Initial settings

Rate FiO2

PIPPEEPTrigger

Page 15: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Type - Volume control

Mode - A/CFlow Tidal volumeTI

Initial settings

Rate FiO2

PIPPEEPTrigger

- 510ml/kg

0.5-1 sec

Page 16: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Type - Pressure control

Mode - A/CFlow Tidal volumeTI

Initial settings

Rate FiO2

PIPPEEPTrigger

Page 17: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Type - Infant ventilator

Mode - A/C, IMVFlow Tidal volumeTI

Initial settings

Rate FiO2

PIPPEEPTrigger

0.3-0.6 sec

Page 18: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Oxygenation

Ventilation

Aims

Tidal volume TI

Rate FiO2

PIP PEEP

Page 19: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Oxygenation

Ventilation

Aims

Tidal volume TI

Rate FiO2

PIP PEEP

Page 20: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Modes•IMV•PSV•CPAP•T-tube

Weaning

Tidal volume TI

Rate FiO2

PIP PEEP

Page 21: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Extubation

CALMS

Conscious

Airway

LungMuscle

SecretionSIMV 5-8PS 5-10

FiO2 < 0.4PEEP < 5

Page 22: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Types of mechanical ventilation Modes of mechanical ventilation - Initial settings full ventilatory support

WeaningExtubation

Ventilator Settings in Pediatric Patients

Page 23: Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University.

Acute lung

injury

Oxygen toxicity VolutraumaShear stress