Selasa, 22 Februari 2011

Mechanical Ventilator Settings

Ventilator is a mechanical breathing aid use to help patients with airway disorders, patients with PaCO2> 50 mmHg and PaO2 <50 mmHg requiring help one of them with ventilator breath.

Things to note on the ventilator:
1. Prisoners airway resistance
2. Komplience lung
3. The desired air volume (flow rate)
4. Humidifier
5. Inspired fractional oxygen consentration (FiO2)
6. Sigh
7. Positive End expiratory Pressure
8. The highest expiratory pressure (pressure Peek Limit)
9. Inspiration and expiratory ratio (I / E ratio)

Steps ventilator settings
1. After intubation followed by mechanical pumps
2. See whether elevated asymmetrical chest wall every time inspiration is given and no air leakage sound
3. Select the mode appropriate ventilator patient's condition
4. At the beginning of the use of ventilators provide FiO2 100%, to maintain SatO2> 92%. FiO2 can be derived after the confirmation of the value of oxygen saturation
5. Given tidal volume 8-10 ml / kg, in patients with acute respiratory failure due to neuromuscular disease often membiutuhkan tidal volume of 10-12 ml / kg
6. Determine the rate of breathing and minute ventilation according to clinical state of patients depending on blood pH
7. Use PEEP in diffuse lung damage, PEEP> 15 cmH2O is rarely necessary.
8. High Pressure inspiration PIP> 60 cmH2O, inspiration plateau pressure> 35 cm H2O must be considered
9. If the ventilator requires a flow rate, use the appropriate flow rate to avoid rapid respiration and autoPEEP
10. If there is difficulty in oxygenation, ventilation or excessive high-pressure inspiration, use appropriate medications or change in position
11. Call critical care consultant.

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