Post #1 of 3: What is going on? How can you improve the patient-ventilator interaction? Can you explain what you observe in the graph? The vent is a Hamilton C6 and the mode is (S)CMV aka VC-AC and properly classified by the Taxonomy of the Modes as VC-CMVs. What is the control variable? How do you define what VC is?
I think, Patient is not getting time to exhale properly. Need to increase expiratory time by setting I:E ratio. Corrections in my observation are welcome 🙏
The control variable is volume since square shape flow curve is present and the same amplitude of volume curve for the three appearing breaths. The ventilator here is early cycling and the patient is trying to trigger the ventilator again as he didn't receive the desired volume or Ti didn't meet neural Ti.
Everything fine with assisted breath and volume.Expiratory volume looks low may be because of leakage around OETT.
perform an expiratory hold to assess further
Px is passive. I think this is a sample of pendulluft swing. Maybe decreasing peep will help.
I think triger sensitive should increase so that patient can initiate his effort.
If this is RT (without breath stacking) some say this could be a beneficial asynchrony as it may prevent diaphragm atrophy
Is this flow starvation ?! Pt is asking for more air so increasing vt ?!
Biomedical Engineer at Saadat Company
3wn the inspiratory phase, the patient needs more flow and volume. In this situation, it is better to increase the tidal volume or inspiratory flow. However, in some devices, the ventilator automatically detects the pressure drop caused by the patient's effort during inspiration and switches to pressure control in the same breath to increase flow and volume.