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    Increasing and Decreasing Repspiratory Support PDF

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    Özgür Barışcan Kaya
    This document provides information on various modes of respiratory support: 1. ECMO is used for very severe respiratory failure and involves bypassing the lungs completely by oxygenating blood directly via an extracorporeal membrane machine, but is only available in specialist centres. 2. HFOV allows spontaneous breaths at high levels of PEEP with intermittent pressure releases and consultant guidance is recommended when using this mode. 3. Several other modes are described that can be used to support breathing such as PC, VC, PS, NIV, CPAP and high flow oxygen via nasal cannulae. Guidance is provided on when to consider escalating support or weaning patients from each mode.

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    Increasing and Decreasing Repspiratory Support PDF

    Uploaded by

    Özgür Barışcan Kaya
    32 views1 page
    This document provides information on various modes of respiratory support: 1. ECMO is used for very severe respiratory failure and involves bypassing the lungs completely by oxygenating blood directly via an extracorporeal membrane machine, but is only available in specialist centres. 2. HFOV allows spontaneous breaths at high levels of PEEP with intermittent pressure releases and consultant guidance is recommended when using this mode. 3. Several other modes are described that can be used to support breathing such as PC, VC, PS, NIV, CPAP and high flow oxygen via nasal cannulae. Guidance is provided on when to consider escalating support or weaning patients from each mode.

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    This document provides information on various modes of respiratory support: 1. ECMO is used for very severe respiratory failure and involves bypassing the lungs completely by oxygenating blood directly via an extracorporeal membrane machine, but is only available in specialist centres. 2. HFOV allows spontaneous breaths at high levels of PEEP with intermittent pressure releases and consultant guidance is recommended when using this mode. 3. Several other modes are described that can be used to support breathing such as PC, VC, PS, NIV, CPAP and high flow oxygen via nasal cannulae. Guidance is provided on when to consider escalating support or weaning patients from each mode.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    32 views1 page

    Increasing and Decreasing Repspiratory Support PDF

    Uploaded by

    Özgür Barışcan Kaya
    This document provides information on various modes of respiratory support: 1. ECMO is used for very severe respiratory failure and involves bypassing the lungs completely by oxygenating blood directly via an extracorporeal membrane machine, but is only available in specialist centres. 2. HFOV allows spontaneous breaths at high levels of PEEP with intermittent pressure releases and consultant guidance is recommended when using this mode. 3. Several other modes are described that can be used to support breathing such as PC, VC, PS, NIV, CPAP and high flow oxygen via nasal cannulae. Guidance is provided on when to consider escalating support or weaning patients from each mode.

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    © All Rights Reserved
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    of 1

    Respiratory support Lungs bypassed completely.

    Blood oxygenated directly via


    extracorporeal membrane machine.
    For very severe respiratory failure only. ECMO
    Specialist centres only.

    Used in severe respiratory failure.


    Consider Requires heavy sedation, completely different
    escalating if mode of action to other ventilator modes.
    patient needs HFOV
    more than
    50% O2 Allows spontaneous breaths with at high PEEP,
    with intermittent pressure releases. Consultant
    guidance recommended Wean by reducing
    APRV O2, frequency and
    pressures (medically
    led) until patient
    Gives set number of breaths per minute (set with f ) ready for trial of
    which will be delivered whether or not the patient takes conventional mode
    PC or VC
    their own pressure supported breaths.
    (BIPAP or SIMV) Weaning medically
    Can be used to take over patients breathing completely,
    or protocol led
    or weaned to allow the patient to do more of the work.
    + PS (ASB) & CPAP

    Like NIV, but usually delivered via ETT or tracheostomy


    All breaths are spontaneous - if the patient doesn’t
    breathe, the machine won’t deliver a breath. PS (ASB) Optimise tidal volumes and ABGs
    +CPAP using pinsp, or VT, PEEP and rate (f).
    Wean by reducing rate, or increasing
    amounts of increasing time spent on
    Like CPAP, but helps the patient take bigger breaths by ASB alone
    also pushing the gas into the patient when they
    breathe in (pressure support). NIV Wean by reducing top pressure, or
    Needs tight fitting mask, can be difficult to tolerate. (not home increasing time periods spent on
    machines)
    CPAP alone.

    Does not allow airway pressure to return to zero at end


    of breath .Helps splint alveoli and small airways open. CPAP
    Reduces work of breathing, improves oxygenation, and Occasionally used for a short while to
    Added to hi-flo
    helps to mobilise secretions. circuit, bridge patient between extubation
    Need to wear tight fitting mask if artificial airway or through vent as and using O2 mask without support
    not in place PEEP

    Accurate O2 delivery, good humidification High flow


    Reasonably tolerated, can feel hot and Wean by reducing amount of CPAP
    claustrophobic oxygen, via (if >5) or increasing time periods
    face mask spent on High flow

    Accurate O2 delivery, excellent


    humidification. HFNC
    Comfortable, well tolerated,
    delivers very low level of CPAP. (High flow Wean to low flow O2, when
    nasal cannulae) stable on < 45% O2

    Can deliver up to 90% O2.


    Can’t wean O2 Non-
    Short term use only – no
    humidification rebreathe
    mask Consider weaning
    if patient needs
    Inaccurate O2 less than 45% O2*
    delivery (unless Low flow
    venturi) oxygen
    Max 65% O2.
    Humidification can via face
    be added mask

    Max Nasal Most patients will be more comfortable


    5 lpm
    cannulae with nasal cannulae rather than a mask;
    consider swapping from mask if on
    <35% / 5lO2
    Clare Hepworth 2020

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