In volume control mode, <unk><unk> alarm sounds. In<unk> control mode (low) volume alarm sounds--BOTH signify similar problems and troubleshoot with the following 4 maneuvers.
Need to measure peak plateau<unk> P(Plat) not only peak airway<unk> P(Peak).
Press and hold the “inspiratory hold” button-waveform shows peak<unk> and then lower plateau.
P(Plat) >30 thought to be potentially injurious to lung.
P(Plat) reflects equilibration of airway<unk>  without flow, accounts for airway resistance.
Press and hold the “inspiratory hold” button-waveform shows peak<unk> and then lower plateau.
When airway resistance<unk> , P(Peak)>> P(Plat)
Normal P(Peak)-P(Plat) < 5cm H2O
Airway resistance increased with: asthma, mucus plugging, small tube, tube kinking, tube obstructed
Normal P(Peak)-P(Plat) < 5cm H2O
Airway resistance increased with: asthma, mucus plugging, small tube, tube kinking, tube obstructed
Airway resistance increased with: asthma, mucus plugging, small tube, tube kinking, tube obstructed
Flow at end of expiration has not stopped, ie breath stacking, ie need more time to exhale and each breath adding volume to lungs
Consequence of dynamic hyperinflation
Look to make sure expiratory flow returns to baseline.
If you suspect dynamic hyperinflation, perform “expiratory hold”, then PEEP on<unk>  may be<unk> er than PEEP on<unk>  settings
Differences in PEEP with “expiratory hold” and PEEP set on<unk>  suggest hyperinflation.
Ventilator high pressures
The difficult airway
Tracheostomy complications
Tracheostomy bleeding
Phrenic nerve/diaphragmatic stimulators complications
Tracheostomy dislodgement
CVC catheter problems
Tracheostomy infection