High-Frequency Ventilation- Basics and Practical Applications

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Appendix Babylog 8000 Combining HFV with conventional ventilation modes High-frequency oscillations can be superimposed whenever the patient could otherwise breathe spontaneously from the continuous flow. This results in the following possible combi nations: CPAP and HF HF cycles are continuously applied, superimposed on the CPAP level. In this situation the MAP equals the CPAP. IPPV/IMV and HF HF cycles are applied during the expiratory phases between the mandatory strokes. About 100 ms before a mandatory stroke the oscillations stop, and about 250 ms after the stroke they continue. Two precautions against airtrapping are built in: Firstly, the short pause after each stroke is to give the patient sufficient time to exhale; Secondly, the oscillations always start with an expiratory phase (see figure 12.1). Due to the mandatory ventilation strokes the actual mean airway pressure now results from conventional cycles and the set PEEP. SIMV and HF This mode basically functions like the combination of IPPV and HF, but now the oscillations stop about 300 ms before the time window in which the ventilator looks for a spontaneous breathing effort for triggering. This is necessary to detect spontaneous breath ing without disturbance from the HF oscillations. Of course this reduces the time available for oscillations. With poor ventilatory drive no oscillations occur until the next mandatory cycle, resulting in long episodes of apnea. Applying SIPPV and HFV simultaneously is not possible. Monitoring during HFV As in conventional ventilation the Babylog 8000 monitors pressure and flow, but displays the real-time waveforms alternatively. Some monitoring capabilities have been specially adapted to highfrequency ventilation: 2 – DCO 2 = VT HF * f: gas transport coefficient (cf. 3.4) 44
Appendix Babylog 8000 – VT HF : inspired tidal volume, averaged over several cycles – MV IM : nspired minute volume of IMV breaths – V TIM : inspired tidal volume of IMV breaths Figure 12.1: Pressure and flow waveforms: The first oscillation after the IMV breath starts with an expiratory phase. 45
Page 1 and 2: D-20330-2010 High-Frequency Ventila
Page 3: High-Frequency Ventilation Basics a
Page 6 and 7: Table of Contents 1 High-frequency
Page 8 and 9: Commercial ventilators, Effects 1 H
Page 10 and 11: Commercial ventilators, Effects - T
Page 12 and 13: Commercial ventilators, Effects 2.1
Page 14 and 15: Characteristic parameters and contr
Page 20 and 21: Indications; HFV+IMV 4 Indications
Page 22 and 23: Indications; HFV+IMV 5 Combining HF
Page 24 and 25: Management of HFV 6 Management of H
Page 26 and 27: Management of HFV HFV: Continuation
Page 28 and 29: Management of HFV Then switch back
Page 30 and 31: Monitoring during HFV Volume Pressu
Page 32 and 33: Strategies for HFV 8.2 HFV for inho
Page 34 and 35: Strategies for HFV 8.5 HFV for Pulm
Page 36 and 37: Complications, contrainindications
Page 38 and 39: Complications, contrainindications
Page 40 and 41: Summary 11 Summary High-frequency (
Page 42 and 43: Appendix Babylog 8000 The pressure
Page 46 and 47: Appendix Babylog 8000 12.1.1 Adjust
Page 48 and 49: Appendix Babylog 8000 Under ‘Sett
Page 50 and 51: Appendix Babylog 8000 Oszillatory v
Page 52 and 53: Appendix Case reports 12.2 Case rep
Page 54 and 55: Appendix Case reports Figure 12.4 d
Page 56 and 57: Appendix Case reports 0.00: Decisio
Page 58 and 59: Appendix Case reports 12.3 DCO 2 in
Page 60 and 61: Appendix Case reports Lund diagnose
Page 62 and 63: Appendix Case reports pCO2 Hours af
Page 64 and 65: Appendix Case reports The succes ra
Page 66 and 67: Abbreviations 12.6 Abbreviations BP
Page 68 and 69: Bibliography 13 Bibliography 1. Abb
Page 70 and 71: Bibliography 51. Hülskamp G, Hents
Page 72 and 73: Bibliography 98. Tamura M Tsuchida
Page 74 and 75: Index 14 Index Airleak 20; 32; 36 A
Page 76: HEADQUARTERS Drägerwerk AG & Co. K

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