Conventional Mechanical Ventilation: Initial Settings by B. Grenier | OPENPediatrics

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Conventional Mechanical Ventilation: Initial Settings by Barry Grenier.
Hello. My name's Barry Grenier. I'm the education coordinator in the Respiratory Care Department at Boston Children's Hospital. And today, I'd like to outline a practical approach for choosing initial ventilator settings for a range of pediatric patients being ventilated with a conventional mechanical ventilator.
Now, this discussion assumes that you've got a ventilator that's set up with a circuit and accessories appropriate for your patient's size, and that you put the ventilator through a pre-use check as per the manufacturer's recommendations. And we'll do an overview of a choice of mode of ventilation, choosing ventilator settings that define the mandatory breath type that you're using in that mode of ventilation, choosing the other ventilator settings applicable in that mode, and finally we'll talk a little bit about using pressure support and modes of ventilation that allow spontaneous breaths.
Determining Appropriate Mode of Ventilation.
Now choosing the mode of ventilation may seem daunting due to the proliferation of modes and mode names that have appeared on mechanical ventilators. But it may help to try to simplify the process a little bit by stating that all modes of ventilation can be fit into three main mode families-- Continuous Mandatory Ventilation, Intermittent Mandatory Ventilation, and Continuous Spontaneous Ventilation. And that these modes contain breaths that are either volume-controlled or pressure-controlled.
With Continuous Mandatory Ventilation, all breaths are mandatory. And these would include the so-called assist-control modes that we have traditionally used. The Intermittent Mandatory Ventilation modes offer a combination of mandatory and spontaneous breaths, and Continuous Spontaneous Ventilation would include those modes of ventilation where all breaths are spontaneous. With volume-controlled breaths, the tidal volume and the flow rate are set and delivered consistently from breath to breath to breath.
And to do that, the ventilator will vary the pressure as needed. With pressure-controlled breaths, the ventilator pressure is predetermined and volumes and flows are, to some degree, variable. With pressure-controlled, the target pressure can be set but sometimes-- in some of the newer modes of ventilation-- the pressure's controlled by the ventilator to achieve a target tidal volume. So in modes such as Pressure Regulated Volume Control, if you dig into what's happening with that breath, the breath is volume targeted but it is delivered as a pressure-controlled breath.

[@erikadc2121]

Extra ordinary .. you are helping patients all over the world with your science and humanity ,..Thanks a lot

[@docsanti8971]

As usual, excellent OPEN PEDIATRICS! Thanks.

[@greensahuaro2834]

Many thanks!!!!!!!

[@ponmahi5428]

Outstanding explanation of ventilator settings
I learned . More thank you

[@dr.raghupathi4222]

All the videos of OPENPediatrics are very very useful , thank u 🎉👍🏻

[@JustAnotherTrader]

Amazing........ I'm a paramedic with a LTV 1200 and this really helps figure out your initial settings!

[@MohamedKandilMD]

Outstanding lecture. Very clear and informative. Thank you!

[@tangmariana1769]

A great talk. Thank you so much! Very practical and easy to understand! This is what I need.

[@drsurendraanand8346]

thanx for providing useful basics knowledge

[@zienabfouad3657]

❤❤❤

[@divinagraciaprimero6628]

Easy to understand. Kudos!

[@dionnawalton6069]

great refresher. thank you so much!

[@OPENPediatrics]

Thank you for your feedback. For more videos like this, please visit www.openpediatrics.org.

[@shagia1416]

Very informative sir!! Thank you

[@joseespinosa3861]

Very good exposition .

[@halimanakato1272]

Brilliant lecture, thank you so much. Adequate content, concisely delivered. Please would appreciate looking at specific neonatal cases both premies and term neonates, your general management of those challenging cases. Again great presentation- thank you!

[@omarfarook5165]

Amazing

[@nyinggypo3373]

Thank you sir nicely explained

[@pavaniabeynayake4994]

very good ..

[@islamelgammal2548]

Thanks alot, excellent

[@emantaha5522]

Great

[@najmiusman7028]

Impressive

[@tubeysr]

Very nice video. Would be glad to learn more in details about ventilation and application

[@OPENPediatrics]

Hi! You can use our ventilator simulator here: www.openpediatrics.org/assets/simulator/ventilator-simulator You'll have to log-in if you want to track your process. Site registration is free and can be done here: www.openpediatrics.org/user/register

[@pradeepsihare1]

Nicely

[@duaakandooh9481]

,I am iraSo thankful for everyone help in this video help me a lot and I hope help many children

[@sadiasyed237]

How we can set tidal volume n delta pressure

[@paediatriciandoctorzahidhu8360]

How and when to to set delta pressure?