Measurement Error in Pressure Control Modes of Mechanical Ventilation Leads to Unsafe Ventilator Settings: A Simulation Study

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 316A
Author(s):  
Madhu Sasidhar ◽  
Robert Chatburn
Keyword(s):  
Mechanical Ventilation ◽  
Measurement Error ◽  
Simulation Study ◽  
Pressure Control ◽  
Ventilator Settings

Emergency Pediatric Noninvasive Ventilation and Invasive Mechanical Ventilation

2020 ◽  
pp. 51-63
Author(s):  
Garrett S. Pacheco
Keyword(s):  
Mechanical Ventilation ◽  
Emergency Physician ◽  
Oxygen Therapy ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Supportive Treatment ◽  
Airway Clearance Therapy ◽  
Respiratory Complaints ◽  
Ventilator Settings

Respiratory complaints are common conditions for children to present to emergency departments. Typically, patients respond to simple supportive treatment, whether it is airway clearance therapy, oxygen therapy, or bronchodilators. When these patients are critically ill, they often require aggressive oxygenation/ventilation with noninvasive strategies, or even tracheal intubation. The use of noninvasive positive pressure ventilation has led to a significant reduction in the necessity for endotracheal intubation in children. The emergency physician should be familiar with the indications and appropriate application of these modalities. Furthermore, when patients require invasive mechanical ventilation, the emergency physician should have an understanding of initial ventilator settings, troubleshooting alarms, and an approach to the decompensating pediatric ventilated patient.

Respiratory Acidosis in the Intensive Care Unit

2020 ◽  
pp. 73-84
Author(s):  
Jared Staab
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Pressure Control ◽  
Lower Airway ◽  
Thyroid Storm ◽  
Ventilator Induced Lung Injury ◽  
Non Invasive Ventilation ◽  
Central Nervous System Depression ◽  
Fraction Of Inspired Oxygen ◽  
Lower Airway Obstruction

This chapter explains that the interpretation of acid–base abnormalities is an essential skill required when caring for critically ill patients. The differential causes of respiratory acidosis include central nervous system depression, upper and lower airway obstruction, and hypermetabolic states with increased production of CO2, such as malignant hyperthermia and thyroid storm. The treatment for hypoxic and hypercarbic respiratory failure involves reversing the offending agents if applicable, treatment of the underlying cause, and mechanical ventilation. The 2 commonly used strategies for mechanical ventilation are non-invasive ventilation with a mask and endotracheal intubation. The selection of ventilation strategy is dependent on numerous patient factors. Clinicians must set respiratory rate, tidal volume, positive end-expiratory pressure, inspiratory flow, fraction of inspired oxygen, mode (volume versus pressure control), and the amount of assistance per breath. All need to be tailored toward each patient’s specific goals. In patients with severe acidosis, there may be a temptation to hyperventilate in order to treat the hypercarbia and hypoxia as quickly as possible. This can be deleterious as high tidal volumes may lead to ventilator-induced lung injury due to volutrauma, cytotrauma, and barotrauma.

scholarly journals Measurement error in time-series analysis: a simulation study comparing modelled and monitored data

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Barbara K Butland ◽  
Ben Armstrong ◽  
Richard W Atkinson ◽  
Paul Wilkinson ◽  
Mathew R Heal ◽  
...  
Keyword(s):  
Time Series ◽  
Measurement Error ◽  
Time Series Analysis ◽  
Simulation Study ◽  
Series Analysis

A Simulation Study on Max Pressure Control of Signalized Intersections

2018 ◽  
Vol 2672 (18) ◽  
pp. 117-127 ◽  
Author(s):  
Xiaotong Sun ◽  
Yafeng Yin
Keyword(s):  
Simulation Study ◽  
Control Strategy ◽  
Network Performance ◽  
Pressure Control ◽  
Local Information ◽  
Signalized Intersections ◽  
Signal Control ◽  
Traffic Signal Control ◽  
Distributed Approach ◽  
Cyclic Approach

In this paper, a decentralized traffic signal control strategy named max pressure control is reviewed and examined. This control strategy aims at optimizing overall network throughputs, but applies a distributed approach that only requires local information to generate timing plans for each intersection. A Vissim simulation study is conducted to compare existing max pressure schemes. The results show that a recently proposed cyclic-based approach performs more poorly than the original non-cyclic approach. Further, to address two issues that hinder existing schemes: frequent changes of phase and queue spillover/blockage, two modifications are suggested. The simulation reveals that network performance can be improved after modifications.

scholarly journals Consequences of measurement error in qPCR telomere data: A simulation study

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216118 ◽  
Author(s):  
Daniel Nettle ◽  
Luise Seeker ◽  
Dan Nussey ◽  
Hannah Froy ◽  
Melissa Bateson
Keyword(s):  
Measurement Error ◽  
Simulation Study

scholarly journals Comparing the Intellivent-ASV® Mode with Conventional Ventilation Modes during Weaning after Uncomplicated Cardiac Surgery

2021 ◽  
Vol 18 (3) ◽  
pp. 36-45
Author(s):  
А. А. Eremenko ◽  
R. D. Komnov ◽  
P. А. Titov ◽  
S. А. Gerasimenko ◽  
D. А. Chakal
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Adverse Events ◽  
Tidal Volume ◽  
Driving Pressure ◽  
Conventional Ventilation ◽  
Respiratory Support ◽  
Control Group ◽  
Ventilation Modes ◽  
Ventilator Settings

The objective: to compare efficacy and safety of Intellivent-ASV® with conventional ventilation modes during weaning in the patients after cardiac surgery.Subjects and methods. In this randomized controlled trial, 40 adult patients were ventilated with conventional ventilation modes and 40 with Intellivent-ASV after uncomplicated cardiac surgery. Eight physicians were involved in the study.Care of both groups was standardized, except for the modes of postoperative ventilation.We compared:- The physician’s workload, through accounting number of manual ventilator settings and time they spent near the ventilator in every group,- Duration of tracheal intubation in ICU,- Evaluation of ventilation safety by considering driving pressure, mechanical power, positive end expiratory pressure, and tidal volume level,- The frequency of adverse events, postoperative complications, and lethality.Results. There were significant differences in the duration of respiratory support in ICU: 226 ± 31 min (Intellivent Group) vs 271 ± 78 min (Control Group) (p = 0.0013).In Intellivent Group, the number of manual ventilator settings and time spent by physicians near the ventilator before tracheal extubation were significantly lower: 0 vs 4 (2–6), and 35 (25–53) sec vs 164 ± 69 sec respectively (p < 0.001 in both cases).Intellivent-ASV provided significantly more protective ventilation through reduction in the driving pressure, tidal volume, FiO2 and PEEP levels but no difference was noted between paO2/FiO2 ratio. ∆P and Vt were significantly lower in Intellivent Group – ∆P on mechanical ventilation was 6 (5–7) cm H2O vs 7.25 (6.5–9.5) cm H2O (p < 0.001); Vt on mechanical ventilation was 6 (5.2–7) vs 7 (6–9.5) ml/kg/PBW (p = 0.000003). PEEP and FiO2 levels were also significantly lower in Intellivent Group, PEEP on mechanical ventilation was 5 (5–7.5) cm H2O vs 7 (5–11.5) cm H2O and FiO2 level was 26 (22–30) % vs 34 (30–40) %.There were no significant differences between the groups in frequency of adverse events and duration of ICU and hospital stay.Conclusion. Application of Intellivent-ASV mode after uncomplicated cardiac surgery provides more protective mechanical ventilation and reduces the physician’s workload without compromising the quality of respiratory support and safety of patients.

Respiratory muscle recruitment during mechanical ventilation: Effects of ventilator settings

2015 ◽  
Author(s):  
Lisanne H. Roesthuis ◽  
Jonne Doorduin ◽  
Johannes G. Van der Hoeven ◽  
Leo M.A. Heunks
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Muscle ◽  
Muscle Recruitment ◽  
Ventilator Settings
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