On the simple ventilator pressure waveform we have time on the x axis and pressure on the y axis. This is a square shaped waveform.

Phases of breathSo on the first part of the waveform the pressure is at the baseline and nothing is happening, but then at (1) the pressure rises in a vertical fashion as air is entrained into the lung. But what has happened to cause this to occur?

What has triggered the start of inspiration at (1)?

The inspiration phase is then at (2).

The breath then ends (3) at end inspiration.

Then we reach baseline or expiratory phase again (4).

This whole process takes place over a total cycle time, in other words how long does this whole breath take. The whole breath includes both the inspiration time, the expiration time and any pauses in between. In the diagram above the cycle starts at (1) and finishes at the end of (4).

So let us assume that the ventilator is giving 12 breaths every minute, a rate we can set. We need then to divide 60 seconds by 12 which will give us a total cycle time of 5 seconds.

From this we can work out how much of that total cycle time is inspiration and how much is expiration- this is the inspiration:expiration ratio or I:E ratio.

We can set our inspiratory time via the ventilator in many modes of ventilation. So let us assume that we set our inspiratory time or Ti to 1 second. So as our total cycle time was 5 seconds, we must have an expiratory time of 4 seconds. This will then give us an I:E ratio of 1:4.

So, in this example, we have four times as long in expiration as we do in inspiration.

So what will happen if we decrease the respiratory rate to 10 breaths per minute for example? This will mean that we now have 6 seconds per breath. If we don’t change the Ti, so that inspiration still takes 1 second then expiration will now take 5 seconds. The I:E ratio has changed to 1:5. Expiration now takes five times longer than inspiration.

 Learn more about this from Ollie Pooles fabulous YouTube channel.….

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Intubation
6 Ways To Be Better With a BVM
Mechanical Ventilation- Physiologic Effects
Anatomy of Adult ETT
Mechanical Ventilation- Terminology
Mechanical Ventilation- Modes of Ventilation I
Mechanical Ventilation- Modes of Ventilation II
Mechanical Ventilation- Pressure/Volume/Flow Loops
Mechanical Ventilation- Peak Pressure and Plateau Pressure
PEEP (Positive End Expiratory Pressure)
Increase the rate or the tidal volume
Ventilation/Perfusion
Ventilation Screen- What do some of those numbers mean?
Phase Variables
I:E ratios and total cycle time.
Why do we ventilate?.
Volume controlled ventilation and compliance.
Lung compliance.
How do I describe how my patient is being ventilated?
Pressure/Volume loop
AC versus SIMV
A-a gradient
Pressure Support
Pressure Support Ventilation Curves
Pressure/Volume/Flow Curves

 

Originally posted 2015-04-06 07:00:34. Republished by Blog Post Promoter

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