Quick reference guide | Atlan SW 2.0n 39
Principles of operation
9.1.5.2 CPAP / PSV
– Spontaneous breathing
– Spontaneous breathing with continuous positive pressure level with or without pressure
support
Each detected inspiratory effort at CPAP level induces a patient-triggered, flow-controlled,
and pressure-supported breath. Point in time, number, and duration of pressure-supported
breaths are controlled by the patient. When no inspiratory effort is detected, mandatory
breaths are delivered at the set minimum respiratory rate RRmin and with pressure support
∆Psupp.
Patient-triggered breaths are ended as soon as the inspiratory flow falls below the flow
defined by the Insp term setting. The duration of a machine-triggered breath is additionally
defined by the patient category and the set minimum respiratory rate RRmin.
Purely spontaneous breathing at CPAP level can be achieved by setting ∆Psupp to Off. In
this case, the patient does not receive any more pressure-supported breaths and RRmin
does not trigger any more mandatory breaths.
9.2 CO2 measurement with pediatric patients and neonates
9.2.1 Influence of the dead space
To enable effective gas exchange even with small tidal volumes, the dead space has to be
as small as possible when ventilating smaller pediatric patients (VT < approx. 30 mL) and
neonates. Components between the Y-piece and the endotracheal tube, e.g., filters, present
an additional dead space. These components should be avoided or be as small as possible.
Depending on the sampling site, ventilation influences such as turbulence at the Y-piece can
result in unusual waveform shapes during the CO
2 measurement.
As a consequence, the CO
2 waveform, for example, may fall at the end of the expiration
before the inspiration is executed, in contrast to the normal course of the waveform. In
addition, cardiogenic oscillation can occur.
Generally, the measured etCO
2 values are still valid, as these measured values correspond
to the maximum expiratory values and do not follow the course of the CO
2 waveform.
In the case of stronger influences, the measured etCO
2 values may be distorted.
37888
100 CO
0
2
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