Pediatric Critical Care Study Guide by Steven E. Lucking Frank A. Maffei Robert F. Tamburro & Neal J. Thomas

Author:Steven E. Lucking, Frank A. Maffei, Robert F. Tamburro & Neal J. Thomas
Language: eng
Format: epub
Publisher: Springer London, London

MONITORING AIRWAY PRESSURES AND GAS FLOW DURING MECHANICAL VENTILATION

Although mechanical ventilation may be life-saving in the asthmatic with respiratory failure, there exists the potential for further worsening of gas exchange after the institution of positive pressure. Monitoring changes in airway dynamics during mechanical ventilation of the asthmatic child is essential. Serially measurements of peak inspiratory pressures (PIP), plateau pressures and monitoring for the development of progresive hyperinflation enables the clinician to respond to dynamic airway changes that are common during mechanical ventilation for asthma.

Peak inspiratory pressures are often used as a proxy for distal alveolar pressure. However, during asthma, elevated airway resistance causes peak inspiratory pressure to be poorly reflective of peak alveolar pressure. Instead, serial measurements of both plateau and peak pressures better evaluate airway and lung changes during the mechanical ventilation of asthmatic child.

Measurement of peak inspiratory pressure allows assessment of the dynamic compliance of the respiratory system:

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