scholarly journals An Evaluation of Peak Inspiratory Pressure, Tidal Volume, and Ventilatory Frequency During Ventilation With a Neonatal Self-Inflating Bag Resuscitator

2012 ◽  
Vol 57 (4) ◽  
pp. 525-530 ◽  
Author(s):  
M. A. Bassani ◽  
F. M. Filho ◽  
M. R. de Carvalho Coppo ◽  
S. T. Martins Marba
Keyword(s):  
Tidal Volume ◽  
Peak Inspiratory Pressure ◽  
Inspiratory Pressure ◽  
Ventilatory Frequency

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

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 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

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

Effect of ventilatory drive on the perceived magnitude of added loads to breathing

1982 ◽  
Vol 53 (4) ◽  
pp. 901-907 ◽  
Author(s):  
J. G. Burdon ◽  
K. J. Killian ◽  
E. J. Campbell
Keyword(s):  
Power Function ◽  
Muscle Force ◽  
Peak Inspiratory Pressure ◽  
Normal Subjects ◽  
Inspiratory Pressure ◽  
Resistive Load ◽  
Sensory Magnitude ◽  
Magnitude Scaling ◽  
Ventilatory Drive ◽  
Resistive Loads

Using open-magnitude scaling we studied the importance of ventilatory drive on the perceived magnitude of respiratory loads by applying a range of externally added resistances (2.1–77.1 cmH2O X l-1 X s) to normal subjects at rest and at three increasing levels of ventilatory drive induced by exercise, CO2-stimulated breathing, and hypoxia. Under all conditions studied the perceived magnitude of the added loads increased with the magnitude of the resistive load and as the underlying level of ventilatory drive increased. When the results were expressed in terms of peak inspiratory pressure, the perceived magnitude was related to the magnitude of the peak inspiratory pressure by a power function (mean r = 0.97). These results suggest that the perceived magnitude of added resistive loads increased with increasing ventilatory drive, in such a manner that the increase in sensory magnitude is proportional to the increase in the inspiratory muscle force developed and suggests that something dependent on this force mediates the sensation.

Gas-Powered and Portable Ventilators: An Evaluation of Six Models

1992 ◽  
Vol 7 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Jerry P. Nolan ◽  
Peter J.F. Baskett
Keyword(s):  
Tidal Volume ◽  
Minute Ventilation ◽  
Pressure Gauge ◽  
Inspiratory Pressure ◽  
Pressure Relief ◽  
Patient Transport ◽  
Cardio Pulmonary Resuscitation ◽  
Air Mixing ◽  
Pressure Relief Valves ◽  
Manual Methods

AbstractIntroduction:Gas-powered resuscitators (ventilators) designed to be used primarily for resuscitation should be basic and simple to use. They offer many advantages over manual methods of ventilation during in-hospital cardiopulmonary resuscitation. Portable ventilators intended for critical care transport require additional, more sophisticated features such as: adjustable pressure limiting valves, air-mixing, airway pressure gauge, independent tidal volume and rate controls, and a Positive End-Expiratory Pressure (PEEP) valve. The performance of six gas-powered resuscitators/portable ventilators (TransPAC, Oxylog, Ambu Matic, ERA 2000, Uni-Vent, and MARS) was evaluated.Methods:The accuracy of volumes delivered to a test lung at three different compliance and resistance settings, was assessed for each ventilator prior to clinical evaluation during cardio-pulmonary resuscitation (CPR) and patient transport.Results:In each circumstance, measured tidal volumes and levels of minute ventilation decreased as resistance was increased and compliance reduced. Much of this loss of measured tidal volume occurred through inspiratory pressure relief valves that tended to start leaking at pressures below the preset level. Increasing levels of back-pressure resulted in further reductions in tidal volume when the ventilators were tested using the air-mix mode (available on three of the devices). In general, each resuscitator functioned well when used during CPR within the hospital.Conclusions:Each resuscitator tested failed to deliver the preset volumes and this must be considered during their use. Inspiratory pressure relief valves for all but one of the ventilators tested would not permit the delivery of adequate levels of ventilation in patients with low pulmonary compliance and/or high airway resistance.

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