Airway Occlusion at 0.1 Second (P0.1)
In previous post I provide a brief description of the P0.1 and how one can apply this to adjusting settings on the ventilator [1,2] and provide greater detail in my book [3].
However, how does one obtain this measurement?
Fortunately, modern mechanical ventilators have this as a software option.
Even though the procedure for obtaining a P0.1 is automated, it is a little different on each device.
PB 840
The above video demonstrates how to obtain a P0.1 using the PB840.
Draeger Evita XL
Image 1: Draeger Evita XL screen with special procedure tab highlight in yellow. |
1. Select the "special procedures" tab, as pictured in image
2. Select the "Diagnostics" tab, pictured in image 2.
Image 2: Draeger Evita XL screen, showing the diagnostic tab. |
3. The operator can perform the procedure or set a interval for a automated procedure (see image 3). Setting a time interval is beneficial for trending responses to ventilator changes.
Image 3: Diagnostic tab cropped to show procedure options. |
Hamilton Ventilators
1. To obtain P0.1 measurements the trigger has to be set to a "pressure" trigger.
2. P0.1 is continuously measured for spontaneous efforts (as long as pressure trigger is selected).
3. This value is displayed as a monitored value and can also be trended (see image 4).
Image 4: Hamilton G5 screen shot, showing the P0.1 value located under the "Monitoring" tab. |
Respironics Esprit
1. The P0.1 maneuver is under the "MIP/P0.1" tab (image 5).
Image 5: MIP/P0.1 tab of the Respironics Esprit ventilator. |
2. The screen provides the time and date of the last maneuver for comparison (image 6).
Image 6: A series of P0.1 maneuvers performed for comparison. |
The above examples show how the operator can easily perform this diagnostic maneuver. I would encourage all practitioners to apply this assessment into daily clinical practice.
How to apply it?
These are a few examples of application to get one started (links below):
Adaptive Pressure Control Ventilation and Severe Sepsis a Grueling Combination.
Clinical Application of P0.1.
The Problem with Adaptive Pressure Control Modes of Ventilation: a Case Study.
Clinical Application of P0.1.
The Problem with Adaptive Pressure Control Modes of Ventilation: a Case Study.