scholarly journals Evaluation of peak inspiratory pressure, tidal volume and respiratory rate during ventilation of premature lambs using a self-inflating bag

2006 ◽  
Vol 82 (4) ◽  
pp. 279-283 ◽  
Author(s):  
Jefferson G. Resende ◽  
Carlos A. M. Zaconeta ◽  
Antônio C. P. Ferreira ◽  
César A. M. Silva ◽  
Marcelo P. Rodrigues ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Peak Inspiratory Pressure ◽  
Inspiratory Pressure

scholarly journals Frequency and Risk Factors for Reverse Triggering in Pediatric ARDS During Synchronized Intermittent Mandatory Ventilation

2020 ◽  
Author(s):  
Tatsutoshi Shimatani ◽  
Benjamin Yoon ◽  
Miyako Kyogoku ◽  
Michihito Kyo ◽  
Shinichiro Ohshimo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tidal Volume ◽  
Respiratory Rate ◽  
Secondary Analysis ◽  
Peak Inspiratory Pressure ◽  
Time Trial ◽  
Pressure Control ◽  
Control Ventilation ◽  
Inspiratory Pressure ◽  
Pressure Peak

Abstract [BACKGROUND] Reverse triggering (RT) occurs when respiratory effort begins after a mandatory breath is initiated by the ventilator. RT may exacerbate ventilator-induced lung injury and lead to breath stacking. We sought to describe the frequency and risk factors for RT amongst ARDS patients and identify risk factors for breath-stacking. [METHODS] Secondary analysis of physiologic data from children on Synchronized Intermittent Mandatory pressure control ventilation enrolled in a single center RCT for ARDS. When children had a spontaneous effort on esophageal manometry, waveforms were recorded and independently analyzed by two investigators to identify RT. [RESULTS] We included 81,990 breaths from 100 patient-days and 36 patients. Overall, 2.46% of breaths were RTs, occurring in 15/36 patients (41.6%). Higher tidal volume and a minimal difference between neural respiratory rate and set ventilator rate were independently associated with RT (p = 0.001) in multivariable modeling. Breath stacking occurred in 534 (26.5%) of 2017 RT breaths, and 14 (93.3%) of 15 RT patients. In multivariable modeling, breath stacking was more likely to occur when total airway delta pressure (Peak Inspiratory Pressure-PEEP) at the time patient effort began, Peak Inspiratory Pressure, PEEP, and Delta Pressure were lower, and when patient effort started well after the ventilator initiated breath (higher phase angle) (all p < 0.05). Together these parameters were highly predictive of breath stacking (AUC 0.979). [CONCLUSIONS] Patients with higher tidal volume and who have a set ventilator rate close to their spontaneous respiratory rate are more likely to have RT, which results in breath stacking over 25% of the time. Trial registration: NIH/NHLBI R01HL124666, Clinical Trials.gov NCT03266016, Registered 29 August 2017, https://clinicaltrials.gov/ct2/show/NCT03266016

Evaluation of peak inspiratory pressure and respiratory rate during ventilation of an infant lung model with a self-inflating bag

2006 ◽  
Vol 0 (0) ◽  
Author(s):  
Jefferson G. Resende ◽  
Cristiane G. Menezes ◽  
Ana M. C. Paula ◽  
Antônio C. P. Ferreira ◽  
Carlos A. M. Zaconeta ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Peak Inspiratory Pressure ◽  
Lung Model ◽  
Inspiratory Pressure

Using Conventional Infant Ventilators at Unconventional Rates

PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 487-492 ◽  
Author(s):  
Stephen J. Boros ◽  
Dennis R. Bing ◽  
Mark C. Mammel ◽  
Erik Hagen ◽  
Margaret J. Gordon
Keyword(s):  
Tidal Volume ◽  
Airway Pressure ◽  
Important Determinant ◽  
Peak Inspiratory Pressure ◽  
Lung Compliance ◽  
Minute Volume ◽  
Inspiratory Pressure ◽  
Positive End Expiratory Pressure ◽  
Inspiratory Time ◽  
Pressure Monitor

The effect of progressive increases in ventilator rate on delivered tidal and minute volumes, and the effect of changing peak inspiratory pressure (Pmax), positive end-expiratory pressure (PEEP), and inspiration to expiration (I:E) ratio at different ventilator rates were examined. Five different continuous-flow, time-cycled, pressure-preset infant ventilators were studied using a pneumotachograph, an airway pressure monitor, and a lung simulator. As rates increased from 10 to 150 breaths per minute, tidal volume stayed constant until 25 to 30 breaths per minute; then progessively decreased. In all, tidal volume began to decrease when proximal airway pressure waves lost inspiratory pressure plateaus. As rates increased, minute volume increased until 75 breaths per minute, then leveled off, then decreased. Substituting helium for O2 increased the ventilator rate at which this minute volume plateau effect occurred. Increasing peak inspiratory pressure consistently increased tidal volume. Increasing positive end-expiratory pressure decreased tidal volume. At rates less than 75 breaths per minute, inspiratory time (inspiration to expiration ratio) had little effect on delivered volume. At rates greater than 75 breaths per minute, inspiratory time became an important determinant of minute volume. For any given combination of lung compliance and airway resistance: (1) there is a maximum ventilator rate beyond which tidal volume progressively decreases and another maximum ventilator rate beyond which minute volume progressively decreases; (2) at slower rates, delivered volumes are determined primarily by changes in proximal airway pressures; (3) at very rapid rates, inspiratory time becomes a key determinant of delivered volume.

scholarly journals Mechanical ventilation. Part II: Basic principles and function of ventilators.

2017 ◽  
Vol 62 (4) ◽  
pp. 334
Author(s):  
K. PAVLIDOU (Κ. ΠΑΥΛΙΔΟΥ) ◽  
I. SAVVAS (Ι. ΣΑΒΒΑΣ) ◽  
T. ANAGNOSTOU (Τ. ΑΝΑΓΝΩΣΤΟΥ)
Keyword(s):  
Mechanical Ventilation ◽  
Tidal Volume ◽  
Respiratory Rate ◽  
Positive Pressure Ventilation ◽  
Anaesthetic Management ◽  
Intermittent Positive Pressure Ventilation ◽  
Assisted Ventilation ◽  
Inspiratory Pressure ◽  
Positive Pressure ◽  
Continuous Positive Pressure

Mechanical ventilation is the process of supporting respiration by manual or mechanical means. When normal breathing is inefficient or has stopped, mechanical ventilation is life-saving and should be applied at once. The ventilator increases the patient's ventilation by inflating the lungs with oxygen or a mixture of air and oxygen. Ventilators play an important role in the anaesthetic management of patients, as well as in the treatment of patients in the ICU. However, there are differences between the anaesthetic ventilators and the ventilators in ICU. The main indication for mechanical ventilation is difficulty in ventilation and/or oxygenation of the patient because of any respiratory or other disease. The aims of mechanical ventilation are to supply adequate oxygen to patients with a limited vital capacity, to treat ventilatory failure, to reduce dyspnoea and to facilitate rest of fatigued breathing muscles. Depression of the central nervous system function is a pre-requirement for mechanical ventilation. Some times, opioids or muscle relaxants can be used in order to depress patient's breathing. Mechanical ventilation can be applied using many different modes: assisted ventilation, controlled ventilation, continuous positive pressure ventilation, intermittent positive pressure ventilation and jet ventilation. Furthermore, there are different types of automatic ventilators built to provide positive pressure ventilation in anaesthetized or heavily sedated or comatose patients: manual ventilators (Ambu-bag), volumecontrolled ventilators with pressure cycling, volume-controlled ventilators with time cycling and pressure-controlled ventilators. In veterinary practice, the ventilator should be portable, compact and easy to operate. The controls on most anaesthetic ventilators include settings for tidal volume, inspiratory time, inspiratory pressure, respiratory rate and inspiration: expiration (I:E) ratio. The initial settings should be between 10-20 ml/kg for tidal volume, 12-30 cmH2 0 for the inspiratory pressure and 8-15 breaths/min for the respiratory rate. Mechanical ventilation is a very important part of treatment in the ICU, but many problems may arise during application of mechanical ventilation in critically ill patients. All connections should be checked in advance and periodically for mechanical problems like leaks. Moreover, complications like lung injury, pneumonia, pneumothorax, myopathy and respiratory failure can occur during the course of mechanical ventilation causing difficulty in weaning.

scholarly journals Expired Tidal Volume and Respiratory Rate during Postnatal Stabilization of Term Newborn Infants Born by Cesarean Delivery

2020 ◽  
pp. 100063
Author(s):  
Susana Baixauli-Alacreu ◽  
Celia Padilla-Sánchez ◽  
David Hervás-Marín ◽  
Inmaculada Lara-Cantón ◽  
Alvaro Solaz-García ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Cesarean Delivery ◽  
Newborn Infants ◽  
Term Newborn

scholarly journals Peak inspiratory pressure requirements in infants born weighing less than 750 g.

1990 ◽  
Vol 65 (10 Spec No) ◽  
pp. 1045-1049 ◽  
Author(s):  
K D Foote ◽  
A H Hoon ◽  
S Sheps ◽  
N R Gunawardene ◽  
R Hershler ◽  
...  
Keyword(s):  
Peak Inspiratory Pressure ◽  
Inspiratory Pressure
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