APRV, BiLevel, BiVent

Name: APRV, BiLevel, BiVent
Rating: 4.3 (2 reviews)

Utilizing Airway Pressure Release Ventilation

Created byK. Scott Richey

Last updated 12/2015

English

English [Auto],

What you'll learn

Participant will become familiar with terminology specific to Airway Pressure Release Ventilation
Participant will become familiar with Mode set-points
Participant will be introduced to indications & contra-indications
Participant will become familiar with initial setup of airway pressure release ventilation
participant will be introduced to optimizing settings for increasing oxygen, decreasing paCo2, & weaning.

Course content

13 sections • 37 lectures • 1h 50m total length

Synopsis of Airway Pressure Release Ventilation0:54
This is a brief overview of airway pressure release ventilation.
Medical Device Manufacturers Modes that Mimic Airway Pressure Release Ventilation4:19
Many ventilator manufacturers have airway pressure release ventilation as a mode on their ventilators. However, due to copyright laws each have their own name for the mode.
Airway Pressure Release Ventilation Mode Classification4:11
If one wants to actually classify APRV this video overviews classification.

Overview of Settings7:43
APRV only has four primary operator set-points, these include P-High, PLow, T-High, & T-Low.
Secondary settings are the Fio2, trigger, pressurization rate, expiratory termination, & Pressure support.
P-High3:08
The P-High setting controls the upper pressure or upper CPAP level. The P-High phase regulates end inspiratory lung volume & is analogues with mean airway pressure.
P-Low2:46
This video describes the P-Low setting.
T-High2:59
The T-High Setting controls the time for the upper CPAP level or P-High phase. The T-High provides sustained recruitment, allowing for improved gas exchange by increasing alveolar surface area & exposure time.
T-Low4:24
The T-Low setting establishes the time interval for the low CPAP phase. This time allows for a intermittent release in airway pressure, which augments PaCO2 removal and off loads the respiratory muscles of the work related to pure CPAP breathing.
Note- T-Low should not be considered as expiratory time, since the patient may exhale throughout the entire P-High phase.

P-High Initial Setting0:38
This lecture provides an overview when initially setting P-High.
Selecting a P-High When Transitioning from Traditional Mechanical Ventilation4:04
Set P-High 2 cmH20 above the measured plateau pressure, from the conventional settings.
Selecting a P-High when Transitioning from HFV2:03
This lecture provides an overview when transitioning from HFOV.
Selecting a P-High Based on the Pressure/Volume Curve5:09
This lecture provides an overview when initially setting P-High, based on P/V curve results.

T-Low Initial Settings0:20
This lecture provides an overview when initially setting T-Low.
Setting T-Low Based on the Expiratory Time Constant3:59
T-Low: Based on the “Expiratory Time Constant Measurement”
Setting T-Low based on the expiratory time constant measurement is simple & precise. Set T-low at the same interval as the measured RCexp value.
Rationale- using this measurement sets the T-Low to maintain lung volume at ~ 75% of the Peak Expiratory Flow Rate. This ensures expiratory lung volume & prevents alveolar closure during the release phase
Setting T-Low Based on the Expiratory Flow Waveform9:13
T-Low: Setting Based on the Expiratory Flow Waveform
Titrate T-Low to obtain a “Peak Expiratory Flow Termination Point” (T-PEFR) at 50-75% of the measured “Peak Expiratory Flow Rate” (PEFR).
Rationale- lung mechanics may change which changes the expiratory time constant, T-Low should be reassessed for optimal setting.
Setting T-Low to achieve lung protective goals7:35
This lecture provides an overview when initially setting T-Low to achieve lung protective goals.

Titrating T-Low2:40
This lecture provides an overview to improve oxygenation by titrating the T-Low setting.
Increasing P-High1:57
This lecture provides an overview to improve oxygenation by increasing P-High.
Increasing T-High & P-High2:28
This lecture provides an overview to improve oxygenation by increasing T-High & P-High.
Titrating P-High Based on Esophageal Manometry5:17
This lecture provides an overview to improve oxygenation by evaluating the esophageal pressure.
Titrating P-High Based on Volumetric Carbon Dioxide5:37
This lecture provides an overview to improve oxygenation by evaluating Volumetric CO2.

Sedation & Spontaneous Frequency0:26
This lecture provides an overview in decreasing PaCO2 by evaluating sedation.
Assessing Expiratory Flow2:52
This lecture provides an overview in decreasing PaCO2 by assessing expiratory flow.
Increasing Minute Ventialtion4:11
This lecture provides an overview in decreasing PaCO2 by increasing minute ventilation.
pH Goals0:11
This lecture provides an overview in decreasing PaCO2 by evaluating pH goals.

Requirements

Video play back capabilities

Description

The purpose of this Air Ventilation System: APRV, Bilevel, Bivent course is to provide the clinician with a handy, easy-to-use reference containing primary information in regards to utilizing APRV as a ventilator modality.

The reference includes:</p>

Overview of APRV
Description of settings
Indications
Relative contra-indications
Procedure (Adult, Pediatric, & Neonatal settings)
Initial setup
Transitioning from conventional mechanical ventilation
Transitioning from High-frequency mechanical ventilation
optimization of settings
increasing O2
decreasing CO2
Weaning

Take this ultimate Air Ventilation System course right now and learn how to use APRV, Bilevel, Bivent.

Who this course is for:

Respiratory Therapist, RT Students, Physicians, Nurses

APRV, BiLevel, BiVent

What you'll learn

Explore related topics

Course content

Introduction3 lectures • 9min

Mode Settings5 lectures • 21min

Indications and Contra-indications2 lectures • 8min

Initial Setup: P-High4 lectures • 12min

Inital Setup: T-High1 lecture • 1min

Initial Setup: P-Low1 lecture • 1min

Initial Setup: T-Low4 lectures • 21min

Initial Settings: Secondary Settings2 lectures • 1min

Optimizing Settings: Improving Oxygenation5 lectures • 18min

Optimizing Settings: Decreasing PaCO24 lectures • 8min

Requirements

Description

Who this course is for: