Ventilator Settings in Pediatric Patients Wanida Paoin Thammasat Hospital,Thammasat University
Dec 18, 2015
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
Volume control ventilator
Pressure control ventilator
Infant Ventilator
Types of mechanical ventilation
Volume control ventilator
V
P
V
V
P
V
Pressure control ventilator
Infant Ventilator - Time cycle, pressure
limit
V
P
V
20
Which Type?
Volume controlV
P
V
V
P
V
Pressure control
InfantV
P
V
20
Expiratory to inspiratory phase
Inspiratory phase Inspiratory to expiratory phase
Expiratory phase
Phases of mecha nical ventilation
ControlAssist/Control IMV/SIMVPSVCPAP
Modes of mechanical ventilation
Modes of mechanical ventilation
Control
P
3 60
Modes of mechanical ventilation
Assist/Control
P
3 60
Modes of mechanical ventilation
IMV
P
3 60
ITP -> venous return -> CO -> LV afterloadAware hyperinflation:Lowest PEEP, Optimal Te, Optimal PIP
WOB: flow pattern, trigger
Detrimental hemodynamic
effects
TypeModeFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
Type - Volume control
Mode - A/CFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
- 510ml/kg
0.5-1 sec
Type - Pressure control
Mode - A/CFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
Type - Infant ventilator
Mode - A/C, IMVFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
0.3-0.6 sec
Oxygenation
Ventilation
Aims
Tidal volume TI
Rate FiO2
PIP PEEP
Oxygenation
Ventilation
Aims
Tidal volume TI
Rate FiO2
PIP PEEP
Modes•IMV•PSV•CPAP•T-tube
Weaning
Tidal volume TI
Rate FiO2
PIP PEEP
Extubation
CALMS
Conscious
Airway
LungMuscle
SecretionSIMV 5-8PS 5-10
FiO2 < 0.4PEEP < 5
Types of mechanical ventilation Modes of mechanical ventilation - Initial settings full ventilatory support
WeaningExtubation
Ventilator Settings in Pediatric Patients
Acute lung
injury
Oxygen toxicity VolutraumaShear stress