Saturday, September 20, 2014

Correcting flow mismatch by increasing ventilator flow rate

Flow mismatch is a common patient ventilatory asynchrony associated with volume ventilation, which may lead to cardiovascular instability, increased oxygen consumption, increased carbon dioxide production, increased patient discomfort and prolonged mechanical ventilation[iv]. Fortunately, flow mismatch can be simply identified with the proper assessment of the pressure waveform.

To correct flow mismatch titrate the flow rate to match the patient’s inspiratory demands. Another corrective action is switching from a constant flow pattern to a decelerating flow pattern this provides a high initial peak flow. One must consider that changes in ventilatory demand may result in unnecessary higher than average assist resulting in ventilator induced diaphragm dysfunction[ii], a lower PaCO2 set-point, and delay in liberation.


Creating Flow Mismatch with a Simulator

Oxylog 3000 Simulator

Why I do not use Draeger ventilator simulators

Flow mismatch: patient ventilator asynchrony associated with volume ventilation

Waveform of the week: Flow Mis-match

Decreasing Dyspnea During Mechanical Ventilation