Postoperative Critical Care for Adult Cardiac Surgical Patients by Ali Dabbagh Fardad Esmailian & Sary Aranki

Author:Ali Dabbagh, Fardad Esmailian & Sary Aranki
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

2.Patient makes an expiratory effort before the ventilator cycles from inhalation to exhalation.

3.Patient desires a larger breath and has persistent inspiratory efforts even as the ventilator has cycled to exhalation.

Ventilator dyssynchrony can lead to increased work of breathing (Leung et al. 1997) and should be addressed first by adjusting the ventilator rather than resorting to deeper sedation (Fig. 11.6).

Fig. 11.6This is a flow time curve which is available on all modern mechanical ventilators. In the first breath the expiratory flow returns to zero and there is no I-i-PEEP. There is incomplete exhalation on the second breath, and expiratory flow is still present before the third breath. This can occur in a cyclical fashion resulting in dynamic hyperinflation and possible hemodynamic compromise

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