Heyer iTernIS ADV, Руководство оператора

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ADL/PED Operative modes | iTernIS ADV
9. 6
The following list contains additional functions that can be selected optionally in
PCV (for further details on their behavior, see the
Menu
chapter):
• Nebulization.
• %O
2
suction.
• Manual inspiration.
• Manual inspiratory/expiratory pause.
• Volume compensation.
• Leak compensation.
• Tube compensation.
The PSV ventilation mode is in the
OPERATIVE MODES
menu under the name of
PSV/CPAP, given that the configuration of the two ventilatory variables is possible
from the same module (the next section describes CPAP). Support pressure is a
spontaneous operative mode where the patient starts and stops the inspiratory
phase. This means maintaining control of respiratory rate, inspiration duration and
delivered tidal volume. Then delivered tidal volume is variable, depending on the
regulated support pressure, the effort of the patient (demand), and respiratory im-
pedance thereof.
Support pressure can be analyzed in three segments of the respiratory cycle:
• BREATHING BEGINNING: the inspiratory phase is always initiated by the patient’s
inspiratory effort. With Inspiratory Sensitivity control, it is possible to configure di -
fferent trigger conditions that imply more or less effort for the patient.
• INSPIRATION COURSE: once the inspiration is triggered, it is necessary to pro -
duce the pressurization of the respiratory system, and that the support pressure
value is maintained throughout the patient’s demand. The pressurization can be
changed quickly with Rise time control, as explained for PCV. Once the pressure
value is reached, it remains stable while flow demand is greater than the one
selected as inspiration-end (see 9.3.2 Expiratory Sensitivity).
• END OF INSPIRATION: the inspiratory phase ends when during its course any of
the following events occurs:
- The progressive decrease of the inspiratory flow reaches a specified percentage
of the peak flow (expiratory sensitivity). This is the inspiration-end natural mecha -
nism. The following two mechanisms exist as patient safety mechanisms.
- The inspiration is prolonged up to 3 s in ADL category or 2 s in PED (for NEO-INF
patient category, inspiration ends if this is prolonged during 1 s).
- Inspiratory pressure exceeds abruptly a value of 14% of the set pressure plus 5
cmH
2
O, for all categories.
9.2.4 | Enabled additional
functions
9.3 | PSV - Pressure
Supported Ventilation
9.3.1 |
Overview