VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
Close loop Ventilation
1. Dr Jean-Michel Arnal Intensive Care Unit. Hôpital Font Pré Toulon France [email_address] Close loop ventilation in the ICU
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5. Positive close loop control C ontroller = i’ x i Valves Signal: Flow= i’ Gain = i P insp Unstable Add complexity Act as auxiliary respiratory muscle Intrabreath
6. Negative close loop control C ontroller = i– i’ Valves Signal: V T actual = i’ V T Target = i P insp Target can be achieved Fast response Adapts to external modifications Interbreath
7. Determination of the target C ontroller = i– i’ Valves Signal: V T actual = i’ V T Target = i P insp Operator set Automatically determined
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12. Commercially available solutions Controlled mode Assisted mode Spont mode PAV NAVA SmartCare Adaptive Support Ventilation IntelliVent®
This study from Australia compared Smartcare with usual weaning in a single unit with a 1/1 nurse patient ratio, with very high qualified nurses. The result didn’t show any difference between control and Smartcare. At least, smartcare works as good as best practice in protocols.
This physiologic figure is the background of ASV. It shows that for a given minute ventilation, there is an optimal respiratory rate that is associated with the minimal work or breathing. Otis showed in the fifty’s that this optimal respiratory rate depends on minute ventilation, dead space and expiratory time constant. Expiratory time constant resume the mechanical characteristics of the respiratory system because it is the product of resistances and compliance.