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Ventilator Settings in
Pediatric Patients
Wanida Paoin
Thammasat Hospital,Thammasat University
Types of mechanical ventilation Modes of mechanical ventilation - Initial settings full ventilatory support
WeaningExtubation
Ventilator Settings in Pediatric Patients
Volume control ventilator
Pressure control ventilator
Infant Ventilator
Types of mechanical ventilation
Volume control ventilator
V
P
V
V
P
V
Pressure control ventilator
Infant Ventilator - Time cycle, pressure
limit
V
P
V
20
Which Type?
Volume controlV
P
V
V
P
V
Pressure control
InfantV
P
V
20
Expiratory to inspiratory phase
Inspiratory phase Inspiratory to expiratory phase
Expiratory phase
Phases of mecha nical ventilation
ControlAssist/Control IMV/SIMVPSVCPAP
Modes of mechanical ventilation
Modes of mechanical ventilation
Control
P
3 60
Modes of mechanical ventilation
Assist/Control
P
3 60
Modes of mechanical ventilation
IMV
P
3 60
ITP -> venous return -> CO -> LV afterloadAware hyperinflation:Lowest PEEP, Optimal Te, Optimal PIP
WOB: flow pattern, trigger
Detrimental hemodynamic
effects
TypeModeFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
Type - Volume control
Mode - A/CFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
- 510ml/kg
0.5-1 sec
Type - Pressure control
Mode - A/CFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
Type - Infant ventilator
Mode - A/C, IMVFlow Tidal volumeTI
Initial settings
Rate FiO2
PIPPEEPTrigger
0.3-0.6 sec
Oxygenation
Ventilation
Aims
Tidal volume TI
Rate FiO2
PIP PEEP
Oxygenation
Ventilation
Aims
Tidal volume TI
Rate FiO2
PIP PEEP
Modes•IMV•PSV•CPAP•T-tube
Weaning
Tidal volume TI
Rate FiO2
PIP PEEP
Extubation
CALMS
Conscious
Airway
LungMuscle
SecretionSIMV 5-8PS 5-10
FiO2 < 0.4PEEP < 5
Types of mechanical ventilation Modes of mechanical ventilation - Initial settings full ventilatory support
WeaningExtubation
Ventilator Settings in Pediatric Patients
Acute lung
injury
Oxygen toxicity VolutraumaShear stress
