pressure support ventilation pressure rise time cycling off criteria
TRANSCRIPT
![Page 1: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/1.jpg)
Pressure Support VentilationPressure rise timeCycling off criteria
![Page 2: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/2.jpg)
Modos Ventilatórios (Chatburn RL, 1992)
CICLOS MANDATÓRIOS CICLOS ESPONTÂNEOS
Controle Disparo Limite Ciclagem Controle Disparo Limite Ciclagem
Ventilação Mandatória Contínua
Volume Tempo PressãoFluxo
Fluxo Volume - - - -
Pressão Tempo PressãoFluxo
Pressão Pressão - - - -
Ventilação Mandatória Intermitente
Volume Tempo PressãoFluxo
Fluxo Volume Pressão PressãoFluxo
Pressão Pressão
Pressão Tempo PressãoFluxo
Pressão Pressão Pressão PressãoFluxo
Pressão Pressão
Ventilação Espontânea Contínua
- - - - Pressão PressãoFluxo
Pressão Fluxo
![Page 3: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/3.jpg)
Tobin M. N Engl J Med 2001;344:1986-1996
![Page 4: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/4.jpg)
Tobin M. N Engl J Med 2001;344:1986-1996
![Page 5: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/5.jpg)
Tobin M. N Engl J Med 2001;344:1986-1996
![Page 6: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/6.jpg)
Tobin M. N Engl J Med 2001;344:1986-1996
![Page 7: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/7.jpg)
PSV: Inspiratory rise time / Cycling-off criteria
Pressurização Ciclagem Pressurização Ciclagem
PB 760 5 – 100% 1 – 45% PF T-Bird 5 – 30% PF
PB 84 5 – 100% 1 – 80% Vela 5 – 30% PF
Evita 2dura 0 – 2s 25% PF Avea 1 - 9 5 – 45% PF
Evita 4 0 – 2s 25% PF Bipap Vision
0.05 – 0.4 s Auto-trak
Evita XL 0 – 2s 25% PF Esprit 0.1 – 0.9 s 10 – 45% PF
Servo-i 0 – 0.4 s 1 – 80% PF LTV1000 10 – 40% PF
Servo-s 0 – 0.4 s 1 – 80% PF Elisee 10 – 40% PF
Galileo 25 – 200 ms 10 – 40% PF e500 1 - 19 5 – 50% PF
![Page 8: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/8.jpg)
Des-sincronia durante a fase de pressurização (pressure delivery phase)
• Pressure rise time
![Page 9: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/9.jpg)
Pressure overshoot
![Page 10: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/10.jpg)
Effect of different inspiratory rise time in ALI (Chiumello, 2003)
Coc TI VT VE PEEPi
PSV 5IRT 0% 40% - - - -
IRT 0% 5%
IRT 40% 40% - - - -
IRT 40% 5%
PSV 15IRT 0% 40% - - - -
IRT 0% 5%
IRT 40% 40% - - - -
IRT 40% 5%
![Page 11: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/11.jpg)
![Page 12: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/12.jpg)
WOB vs. P0.1
![Page 13: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/13.jpg)
Des-sincronia durante a fase de ciclagem (cycling off phase)
• Abertura prematura da válvula expiratória (premature cycling)
• Abertura retardada da válvula expiratória (delayed cycling)
![Page 14: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/14.jpg)
Abertura prematura da válvula expiratória
![Page 15: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/15.jpg)
Abertura retardada da válvula expiratória
![Page 16: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/16.jpg)
Effect of different cycling-off criteria in COPD (Chiumello, 2007)
PEEP TI VT VE PEEPi
PSV 5Coc 5% 0
Coc 40% 0 ↓ ↓ ↓ ↓Coc 5% 6
Coc 40% 6 ↓ ↓ ↓ ↓
PSV 15Coc 5% 0
Coc 40% 0 ↓ ↓Coc 5% 6
Coc 40% 6 ↓ ↓ ↓
![Page 17: Pressure Support Ventilation Pressure rise time Cycling off criteria](https://reader034.vdocuments.mx/reader034/viewer/2022052301/552fc117497959413d8c84a5/html5/thumbnails/17.jpg)