iVent201 Operator's Manual
191
I:E Cycling Dysynchrony:
Detection – Delayed I:E cycling is indicated by High Pressure
alarms or obvious ventilator patient dysynchrony and breath
stacking.
Intervention – Increase the percent of peak flow termination
value under the AB Mode menu. Additionally, consider
decreasing I-time. An air leak may lead to "inspiratory hang
up". This may be corrected by adjusting the full facemask or if a
nasal mask is used, consider switching to a facemask. To
exclude the presence of breath stacking, briefly disconnect the
patient to allow spontaneous decompression. If the
dysynchrony resolves as a result, reconsider settings for I-time
and percentage leak flow termination consistent with clinical
guidelines.
Optimizing expiratory synchrony is of particular importance in
patients with obstructive ventilatory disorders. These patients
generally require prolonged expiratory periods to optimize
airway emptying and minimize breath stacking. In these
patients it is essential to titrate the end inspiratory flow
threshold to achieve good expiratory synchrony. A high flow
threshold (70–90% of peak flow) is recommended. As
previously mentioned, the I-time should also be regulated to
minimize breath stacking if a lower end inspiratory threshold is
chosen.
Premature I:E Cycling:
Detection – Premature I:E cycling is indicated by patient
ventilator dysnchrony with no plateau on the pressure
waveform concomitant with a negative flow deflection.
To Next Page
Loading...
