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840 Quick reference PAV setup October 31, 2010

Posted by PeterD in : Quick Reference , comments closed



APRV, PRVC, PAV September 19, 2010

Posted by admin in : APRV, Featured Articles, Multimedia Library, Strategies, Ventilation , comments closed

Current modes of ventilation explained:



    • Recruitable low compliance lung disorders
    • Lung dysfunction secondary to thoracic restriction i.e.. obesity, acites
    • Inadequate oxygenation with FiO2 > .60
    • PIP> 35 cmH2O and /or PEEP>10 cmH2O
    • Lung protective strategies (high PEEP, low Vt) are failing
  • Can be used with other interventions i.e.. INO therapy, prone positioning

  • APRV

    Airway Pressure Release Ventilation (Power Point)

    Ventilation Modes

    APRV Clinical Guide (From Respiratory Resource)

    Proportional assist ventilation (PAV) November 5, 2008

    Posted by admin in : News, Strategies, Ventilation , comments closed

    PAVProportional assist ventilation (PAV) a significant advance or a futile struggle between logic and practice?


    [From  Thorax Online ]

    Proportional assist ventilation is a promising addition to
    other more conventional modes of mechanical
    ventilation with the theoretical advantage of improving
    patient-ventilator interaction. It may also be of use as a
    diagnostic tool in the control of breathing in
    mechanically ventilated patients.


    PAV Article

    The Buteyko method or Buteyko Breathing Technique January 6, 2012

    Posted by admin in : Education/Studies , comments closed

    The Buteyko method or Buteyko Breathing Technique is a form of complementary or alternative physical therapy that proposes chronic “breathing retraining” as a treatment for asthma as well as other conditions. The method takes its name from the late Ukrainian doctor Konstantin Pavlovich Buteyko (Ukrainian: ???????), who first formulated its principles during the 1950s. This method is based on the assumption that numerous medical conditions, including asthma, are caused by chronically increasedrespiratory rate (hyperventilation). However, this theory is not widely supported in the medical community due to the lack of evidence supporting either the theory behind the method or that it works in practice. This method purportedly retrains the breathing pattern through chronic repetitive breathing exercises to correct for the hyperventilation, which, according to the method’s proponents, will therefore cure asthma as well as any other conditions purportedly caused by hyperventilation. At the core of the Buteyko method is a series of reduced-breathing exercises that focus on nasal-breathing, breath-holding and relaxation.

    Research into the use of the Buteyko method has focused almost exclusively on the treatment of asthma, and have had methodological problems. Studies have not found objective measures to support its use such as improvement in lung function, though there are results showing it could possibly improve subjective measures such as asthma symptoms and quality of lifeReviews of this literature have generally concluded that the evidence is not strong enough to recommend its use for the treatment of asthma based on the available evidence. Those exceptions that have recommended considering its use have noted it should be used with traditional therapies (and not in place of mainstream treatment) and is unlikely to affect or cure the underlying cause of asthma. There is no support for the use of the Buteyko method in other diseases, such as diabetes mellitus or any of the over 150 diseases supporters of this method claim to treat. (wikipedia)





    ABC book for Children (Breathing)


    Video Samples

    Download Book

    Patient – Ventilator Asynchrony: Causes, Solutions and New Modes of Ventilation! (2 handouts) October 31, 2010

    Posted by PeterD in : Education/Studies, Ventilation , comments closed
    Patient – Ventilator Asynchrony:
    Causes, Solutions and New Modes of
    Bob Kacmarek PhD, RRT
    Massachusetts General Hospital,
    Harvard Medical School,

    From the CSRT Website a nice overview of the various modes of ventilation.

    Pressure targeted ventilation better able to match patient demand than volume … of PeakInspiratory Flow, Usually 25%. Some low flow 5 LPM or. 5% of Peak Flow … Proportional Assist Ventilation. PAV based on the equation of motion

    1) KacmarekPAV-NAVA

    Wayne Lawson, MS, RRT

    Department of Respiratory Care

    The University of Texas Health Science Center

    at San Antonio

    2) New Modes of Mechanical Ventilation handout


    Achieving Restful Ventilation: The Impact of Patient-Ventilator Interaction on Sleep October 28, 2010

    Posted by PeterD in : Education/Studies, Ventilation , comments closed

    Karen J Bosma, MD, FRCPC Critical Care Medicine and Respirology


    • PAV(set properly)makes central apneas rare, ensures good patient-ventilator synchrony, may make life easier for the RT, and appears to improve sleep

    – Let the patient drive the ventilator

    • Controlled mechanical ventilation eliminates central apneas, obviates the need for synchronization, and also appears to improve sleep

    Interesting article regarding sleep, synchrony with mechanical ventilation and weaning.


    Physiologic Response of Ventilator-dependent Patients with Chronic Obstructive Pulmonary Disease to Proportional Assist Ventilation and Continuous Positive Airway Pressure October 28, 2010

    Posted by PeterD in : Strategies , comments closed

    Physiologic Response of Ventilator-dependent Patients with Chronic Obstructive Pulmonary Disease to Proportional Assist Ventilation and Continuous Positive Airway Pressure

    The results of this study show that, in ventilator-dependent patients with COPD with difficult weaning, PAV improved minute ventilation and unloaded the inspiratory muscles while CPAP, tailored at a value close to PEEPi,dyn, reduced the patients’ neuromuscular drive and inspiratory effort without significant effects on the breathing pattern. The combination of CPAP and PAV further increased tidal volume and decreased the magnitude of the patients’ inspiratory neuromuscular drive and muscle effort to a level similar to that observed in normal subjects (27, 28).

    Direct Link

    Local Copy

    New Modes and New Concepts in Mechanical Ventilation (Prof Yehia Khater ) August 26, 2009

    Posted by admin in : Strategies, Ventilation , comments closed

    New Ventilation Modes

    •Dual Control

    Within-a-breath switches from PC to VC during the breath

    VAPS and pressure augmentation


    Pressure-Limited, Flow-Cycled Ventilation

    Volume support ventilation VSV Siemens 300

    Variable-pressure-support Cardiopulmonary

    corporation Venturi,

    Pressure-Limited, Time-Cycled Ventilation

    Pressure-regulated volume-control PRVC Siemens 300

    Adaptive pressure ventilation APV Hamilton Galileo

    Auto-flow Draeger Evita 4

    Volume-control Puritan Bennett 840

    Variable pressure control Cardiopulmonary

    corporation Venturi

    •Proportional-Assist Ventilation

    •Adaptive Support Ventilation

    •Automatic Tube Compensation

    •Airway Pressure-Release Ventilation

    Download Article in PDF form


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