Hamilton G5 - Blood Gas and Patient Conditions and Possible Adjustments

624074/07 C-9
Step 5: Alarm settings review and special ASV alarms
When monitoring the breathing pattern, you must review the
alarm settings periodically and set them according to clinically
acceptable values. As described below, ASV changes the
breathing pattern according to the respiratory system mechan-
ics and within the boundaries resulting from the operator’s set-
tings for ASV. However, you can closely monitor ASV
®
’s actions
through the alarm system, since the alarm settings work totally
independent of ASV.
It is possible to select a %MinVol that is incompatible with the
lung-protective rules that govern ASV (for a detailed descrip-
tion, see Section C). For example, the operator could want
a high ventilation for a COPD patient in spite of severe pulmo-
nary obstruction. In such a case, ASV tries to achieve the maxi-
mum possible ventilation and alarms
ASV: Cannot meet
target
. Such a case is shown in Figure C-3, where a high ven-
tilation (300% at 70 kg) was set by the operator for a patient
with severely obstructed lungs (Raw = 40 cmH
2
O/(l/s).
Table C-1. Blood gas and patient conditions and possible
adjustments for ASV
Condition %MinVol change Remarks
Normal arterial
blood gases
None --
High PaCO
2
Increase %MinVol Pay careful atten-
tion to inspiratory
pressures
Low PaCO
2
Decrease %MinVol Pay careful atten-
tion to mean
pressures and oxy-
genation status
High respiratory
drive
Consider increase
in %MinVol
Consider sedation,
analgesia, or other
treatments
Low O
2
saturation None Consider increase
in PEEP/CPAP and/
or Oxygen