Rapid Interpretation of Ventilator Waveforms

by Waugh, Jonathan B.; Harwood, Robert; Deshpande, Vijay M.

• ISBN13: 9780130814272
• ISBN10: 013081427X
• Edition: 1st
• Format: Paperback
• Copyright: 1999-01-01
• Publisher: Prentice Hall

Summary

This book guides readers from the basics in ventilator design, function, and management to advanced interpretations of ventilator waveforms. It features a wealth of illustrations of actual ventilator graphics, beginning with the fundamentals of waveform scalars and loops.

Table of Contents

Preface	vii
VENTILATOR GRAPHICS AND CLINICAL APPLICATIONS	1	(22)
Basic Concepts	1	(1)
Effect of Setting Changes on Waveforms	2	(2)
Effect of Flow Rate on Inspiratory and Expiratory Time	4	(2)
Effect of Resistance and Compliance Changes	6	(2)
Scalars	8	(2)
Modes of Ventilation and Corresponding Scalars	10	(13)
Control Mode	10	(3)
Assist Mode	13	(2)
Sychronized Intermittent Mandatory Ventilation (SIMV)	15	(2)
SIMV with Pressure Support Ventilation (PSV)	17	(2)
SIMV with PSV and Positive End Expiratory Pressure (PEEP)	19	(2)
Pressure Control Ventilation (PCV)	21	(2)
PRESSURE-VOLUME AND FLOW-VOLUME LOOPS	23	(32)
Introduction	23	(4)
Pressure-Volume Loops	27	(5)
Work-of-Breathing	32	(2)
Flow-Volume Loops	34	(3)
Interpretation of Loops	37	(18)
WAVEFORMS FOR COMMON VENTILATOR MODES	55	(22)
Volume-Targeted Scalars	56	(2)
Control	56	(1)
Assist	56	(1)
SIMV	56	(2)
Pressure-Targeted Scalars	58	(2)
Control	58	(1)
Assist	58	(1)
SIMV	58	(2)
Spontaneous Scalars	60	(2)
CPAP	60	(1)
PSV	60	(1)
CPAP with PSV	60	(2)
Combination Modes: Volume-Targeted Scalars	62	(2)
SIMV with CPAP	62	(1)
SIMV with PSV	62	(1)
SIMV with CPAP and PSV	62	(2)
Combination Modes: Pressure-Targeted Scalars	64	(2)
SIMV with CPAP	64	(1)
SIMV with PSV	64	(1)
SIMV with CPAP and PSV	64	(2)
Volume-Targeted Pressure-Volume (P-V) and Flow-Volume (F-V) Loops	66	(2)
Control	66	(1)
Assist	66	(1)
SIMV	66	(2)
Pressure-Targeted P-V and F-V Loops	68	(2)
Control	68	(1)
Assist	68	(1)
SIMV	68	(2)
Spontaneous P-V and F-V Loops	70	(2)
CPAP	70	(1)
PSV	70	(1)
CPAP with PSV	70	(2)
Combination Modes: Volume-Targeted P-V and F-V Loops	72	(2)
SIMV with CPAP	72	(1)
SIMV with PSV	72	(1)
SIMV and CPAP and PSV	72	(2)
Combination Modes: Pressure-Targeted P-V and F-V Loops	74	(3)
SIMV with CPAP	74	(1)
SIMV with PSV	74	(1)
SIMV with CPAP and PSV	74	(3)
COMMON CLINICAL FINDINGS	77	(44)
Changes in Respiratory System Compliance	78	(4)
Decreased Compliance	78	(1)
Inflection Points	79	(1)
Overdistension	80	(1)
Active Exhalation	81	(1)
Airway Obstruction	82	(7)
Bronchospasm: Bronchodilator Benefit Assessment	82	(2)
Air-Trapping	84	(4)
Dynamic Hyperinflation	84	(2)
Early Small Airway Collapse	86	(2)
Kinked Endotracheal Tube	88	(1)
Patient-Ventilator Dys-synchrony	89	(4)
Inadequate Inspiratory Flow Rate	89	(1)
Inappropriate Trigger Sensitivity	90	(2)
Patient and Ventilator Rates Out of Synchrony	92	(1)
Leaks	93	(2)
NEONATAL APPLICATIONS
Introduction	95	(1)
Normal Infant Pulmonary Functions	96	(1)
Normal Scalars, P-V and F-V Loops	97	(8)
Abnormal Waveforms	105	(16)
Improper Sensitivity Setting Scalars	105	(1)
A/C Pressure Control Asychrony Scalars	106	(1)
A/C Pressure Control F-V and P-V Loops	107	(1)
Low Flow Setting Scalars	108	(1)
Breath Stacking Scalars	109	(1)
Breath Stacking F-V and P-V Loops	110	(1)
Obstruction to Expiratory Flow Scalars	111	(1)
Obstruction to Expiratory F-V and P-V Loops	112	(1)
Neonatal Right Mainstem Intubation Scalars	113	(1)
Neonatal Right Mainstem Intubation F-V and P-V Loops	114	(1)
Progression to Extubation Scalars	115	(1)
Progression to Extubation F-V and P-V Loops	116	(1)
Effect of Excessive Inspiratory Pressure on the P-V Loop	117	(1)
Reduced Compliance F-V and P-V Loops	118	(1)
Turbulent Baseline Flow Rate Scalars	119	(2)
Case Studies	121	(10)
Index	131