19. DIFERENCIA REGIONAL DE LAVENTILACION 100% 50% 0 + 10 0 - 10 - 20 - 30 PRESION INTRAPLEURAL VOLUMEN - 10 cm H2O - 2.5 cm H2O LA BASE PULMONAR ESTA RELATIVAMENTE COMPRIMIDA EN REPOSO PERO EXPANDE MEJOR EN INSPIRACION QUE EL APEX
20.
21. Volúmenes y Capacidades Capacidad Pulmonar Total (5800 ml) Capacidad vital (4600 ml) Volumen residual (1200 ml Capacidad Inspiratoria (3500 ml) Capacidad Funcional Residual (2300 ml) Volumen de reserva inspiratoria (3000 ml) Volumen Corriente 450-550 ml Volumen de reserva espiratoria (1100 ml) Volumen residual (1200 ml)
22.
23. 02 OXIGENACION Pi02 Fi02 x (PB - 47) Pi02 0.21 x (760 -47) 0.21 x 713 150 mm Hg Ley de Dalton
26 Here, we can see the pressure and flow time waveforms for different I-times. As the inspiratory time increases, the positive pressure is delivered and then held in the patient’s lung for a longer period of time. Let’s take a look at the advantages and disadvantages of pressure based ventilation.
27 17 One advantage of pressure control ventilation is a decreased risk of barotrauma caused by over distention. Also, the medical community as a whole is focused on minimizing the pressure the lung is exposed to. Longer inspiratory time may recruit collapsed and flooded alveoli and improve gas distribution. One disadvantages is that tidal volumes vary when patient compliance changes, such as with the ARDS or pulmonary edema patient. Setting a low tidal volume alarm or minute volume alarm can alert the clinician to this changing status, and the patient can be re-evaluated. Another issue that arises with increases in inspiratory time, is that the patient may require heavy sedation or chemical paralysis. Newer ventilators on the market incorporate an active exhalation valve that allows the patient to breath spontaneously during the set inspiratory time in pressure control ventilation. It will remain to be seen whether a decrease in paralysis may be the result of this active valve.